Corneal densitometry is a clinically validated method for objectively assessing the transparency of stroma. The technique is currently dominated by Scheimpflug technology. Still, optical coherence tomography (OCT), in which examination of the statistical properties of corneal speckle is undertaken, has also been considered to assess corneal densitometry. In-vivo, the stroma is observed via the epithelium. However, the effect of this external layer on stromal densitometry has not been considered as yet. This study aims to quantify the influence of epithelium integrity on corneal OCT densitometry. OCT images from eleven freshly enucleated porcine eyes before and after epithelial debridement were used. OCT densitometry was investigated at different stromal depths using four metrics of speckle statistics. Results indicate that there exist statistically significant differences in speckle statistics for a given stromal depth depending on the presence or absence of the epithelium. The estimation error in speckle statistics can reach over 20% depending on the stromal depth. The anterior stroma densitometry values are the ones most affected by epithelial integrity. In conclusion, if OCT densitometry stromal parameters are to be considered in absolute terms, it is essential to consider the confounding effect of the epithelial layer in the analysis.
Scheimpflug-based corneal densitometry is a clinically verified method for assessing corneal transparency. Nevertheless, the estimates of corneal densitometry appear to be correlated with age and eye biometry parameters, such as the anterior chamber depth or the pupil size, and that ensues a convoluted conditional estimation problem, where it is difficult to interpret the results. This study aims at devising a methodology for compensating for such confounding factors by using, as a research platform, a commercially available Scheimpflug camera that allows exporting images in a dynamic fashion, allowing averaging the results from multiple acquisitions. Two approaches are considered, one based on appropriately normalizing the line densitometry signal and one based on image histogram equalization. Then, three parameters for describing corneal densitometry are derived including the mean value of backscatter and the scale and shape parameters of the Weibull distribution estimated in regions of interest encompassing parts of corneal stroma. The results show that, unlike the non-normalized measures, the proposed approaches lead to parameters that are not correlated with age nor the eye biometry.
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