Imaging the Corneal Endothelium in Fuchs Corneal Endothelial Dystrophy

Tone, Stephan Ong; Jurkūnas, Ūla V.

doi:10.1080/08820538.2019.1632355

Cited by 24 publications

(23 citation statements)

References 54 publications

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“…Nowe techniki leczenia obejmują zastosowanie wszczepów wolnych komórek śródbłonka, trwają także prace nad wprowadzeniem leczenia opartego na terapii genowej [11][12][13][14]. [38,39]. Badanie przy użyciu kamery Scheimpfluga pozwala na wyodrębnienie grupy pacjentów z subklinicznym obrzękiem rogówki, niewidocznym w badaniu przy użyciu lampy szczelinowej.…”

Section: Wstępunclassified

Dystrofia śródbłonkowa Fuchsa – aktualne poglądy na patofizjologię i leczenie choroby

et al. 2020

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Dystrofia śródbłonkowa rogówki Fuchsa (FECD) jest obustronną, postępującą chorobą dotyczącą komórek śródbłonka rogówki. Powoduje stopniową utratę komórek śródbłonka, doprowadzając do obrzęku istoty właściwej i nabłonka rogówki, a w konsekwencji do pogorszenia jakości widzenia, ostrości wzroku i dolegliwości bólowych oczu. Dystrofia została po raz pierwszy opisana i udokumentowana ponad 100 lat temu, w 1910 r., przez wiedeńskiego okulistę Ernsta Fuchsa na przykładzie 13 pacjentów z obustronnym centralnym zmętnieniem rogówki. Od tego czasu nastąpił daleko idący postęp w zakresie znajomości patogenezy, czynników etiologicznych wywołujących chorobę oraz rozwój metod diagnostycznych i terapeutycznych. Wciąż jednak pozostaje wiele pytań, na które dotychczas nie udzielono jednoznacznej odpowiedzi, zwłaszcza w zakresie uwarunkowań genetycznych i molekularnych patomechanizmów FECD. Celem artykułu poglądowego jest przedstawienie i omówienie klinicznych, genetycznych, patofizjologicznych, diagnostycznych i terapeutycznych aspektów dystrofii Fuchsa. Artykuł koncentruje się również na innowacyjnych metodach diagnostyki obrazowej, w tym na optycznej koherentnej tomografii wysokiej rozdzielczości. Przedstawiono także metody leczenia chirurgicznego oraz nowe, małoinwazyjne techniki, takie jak DWEK – technika descemetoreksji bez wykonywania następczego przeszczepienia czy leczenie z wykorzystaniem inhibitora kinazy Rho (ROCK).

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Section: Wstępunclassified

Dystrofia śródbłonkowa Fuchsa – aktualne poglądy na patofizjologię i leczenie choroby

et al. 2020

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“…Currently, specular microscopy (both contact and non-contact) and in vivo confocal microscopy are capable of imaging the CE and allow for morphometric analysis. 4 These commercially available microscopes automatically determine endothelial cell density (ECD), the percentage of cells which are hexagonal (HEX), and coefficient of variation (CV), which are important parameters in evaluating the CE. However, these microscopes have high operation costs ($25,000 to $30,000), which limit accessibility in resource-scarce settings.…”

Section: Introductionmentioning

confidence: 99%

Low-Cost, Smartphone-Based Specular Imaging and Automated Analysis of the Corneal Endothelium

Mantena¹,

Chandra²,

Pecyna³

et al. 2021

Trans. Vis. Sci. Tech.

Self Cite

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Purpose Specular and confocal microscopes are important tools to monitor the health of the corneal endothelium (CE), but their high costs significantly limit accessibility in low-resource environments. We developed and validated a low-cost, fully automated method to quantitatively evaluate the CE using smartphone-based specular microscopy. Methods A OnePlus 7 Pro smartphone attached to a Topcon SL-D701 slit-lamp was used to image the central corneal endothelium of 30 eyes using the specular reflection technique. A novel on-device image processing algorithm automatically computed endothelial cell density (ECD), percentage of hexagonal cells (HEX), and coefficient of variation (CV) values. These values were compared with the ECD, HEX, and CV generated by a Tomey EM-4000 specular microscope used to image the same set of eyes. Results No significant differences were found in ECD (2799 ± 156 cells/mm 2 vs. 2779 ± 166 cells/mm 2 ; P = 0.28) and HEX (52 ± 6% vs. 53 ± 6%; P = 0.50) computed by smartphone-based specular imaging and specular microscope, respectively. A statistically significant difference in CV (34 ± 3% vs. 30 ± 3%; P < 0.01) was found between the two methods. The concordance achieved between the smartphone-based method and the Tomey specular microscope is very similar to the concordance between two specular microscopes reported in the literature. Conclusions Smartphone-based specular imaging and automated analysis is a low-cost method to quantitatively evaluate the CE with accuracy comparable to the clinical standard. Translational Relevance This tool can be used to screen the CE in low-resource regions and prompt investigation of suspected corneal endotheliopathies.

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“…Currently, specular microscopy (both contact and non-contact) and in vivo confocal microscopy are capable of imaging the CE and allow for morphometric analysis. 4 These commercially available microscopes automatically determine endothelial cell density (ECD), the percentage of cells which are hexagonal (HEX), and coefficient of variation (CV), which are important parameters in evaluating the CE. However, these microscopes have high operation costs ($25,000-$30,000) which limit accessibility in resource-scarce settings.…”

Section: Introductionmentioning

confidence: 99%

Low-cost, Smartphone-based Specular Imaging and Automated Analysis of the Corneal Endothelium

Mantena¹,

Chandra²,

Pecyna³

et al. 2020

Preprint

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PurposeSpecular and confocal microscopes are important tools to monitor the health of the corneal endothelium (CE), but their high costs significantly limit accessibility in low-resource environments. In our study, we developed and validated a low-cost, fully automated method to quantitatively evaluate the CE using smartphone-based specular microscopy.MethodsA OnePlus 7 Pro smartphone attached to a Topcon SL-D701 slit-lamp was used to image normal the central corneal endothelium using the specular reflection technique. Images were automatically processed on-device and endothelial cell density (ECD), percentage of hexagonal cells (HEX), and coefficient of variation (CV) values were determined using our novel image analysis algorithm. The morphometric parameters generated from the images taken by Tomey EM-4000 specular microscope were compared between the testing modalities.ResultsNo significant differences in ECD (2799 ± 156 cells/mm2 vs 2779 ± 166 cells/mm2; p=0.28) and HEX (52 ± 6% vs 53 ± 6%; p=0.50) computed by smartphone-based specular imaging and specular microscope, respectively, were found. A statistically significant difference in CV (34 ± 3% vs 30 ± 3%; p<0.01) was found between the two methods. The concordance achieved between the smartphone-based method and the Tomey specular microscope is very similar to the concordance between two specular microscopes reported in the literature.ConclusionsSmartphone-based specular imaging and automated analysis is a low-cost method to quantitatively evaluate the CE with accuracy comparable to the clinical standard.Translational RelevanceThis tool can be used to screen the CE in low-resource regions and reveal the need for further investigation of suspected corneal endotheliopathies.

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Imaging the Corneal Endothelium in Fuchs Corneal Endothelial Dystrophy

Cited by 24 publications

References 54 publications

Dystrofia śródbłonkowa Fuchsa – aktualne poglądy na patofizjologię i leczenie choroby

Dystrofia śródbłonkowa Fuchsa – aktualne poglądy na patofizjologię i leczenie choroby

Low-Cost, Smartphone-Based Specular Imaging and Automated Analysis of the Corneal Endothelium

Low-cost, Smartphone-based Specular Imaging and Automated Analysis of the Corneal Endothelium

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