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Mini Balaram, William H. Tung, Jerome R. Kuszak, Masahiko Ayaki, Toshimichi Shinohara, Leo T. Chylack; Noncontact Specular Microscopy of Human Lens Epithelium. Invest. Ophthalmol. Vis. Sci. 2000;41(2):474-481.
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© ARVO (1962-2015); The Authors (2016-present)
purpose. To obtain in vivo specular images of human lens epithelial cells (LECs)
from persons with or without age-related cataract (ARC); to identify
features that describe individual aspects of these complex images; to
develop feature scales to quantify the severity of each feature; and to
study the association of these features with LEC count, age, Lens
Opacity Classification System III (LOCS III) classifications and
microscopic features of lens epithelium in ARC.
methods. One hundred fifty-two individuals underwent ophthalmic examinations and
LOCS III cataract classifications. Specular images of lenses were
captured using a modified noncontact corneal specular microscope
(SML-2; Konan, Hyogo, Japan). Enhanced images were graded in a masked
fashion, and the presence or absence and severity of each of four
features in the specular image (“columnar organization,” “linear
furrows,” “puffy clouds,” and “black holes”) was graded on a
four-step scale. The generalized linear model with intraclass
correlation was used to ascertain the statistical significance of
associations between age, sex, LOCS III grade, cell count, and feature
grade. Capsulorrhexis specimens from 29 patients were studied with
correlative light and electron microscopy.
results. LEC density declined with age and was inversely correlated with the
scalar grade for puffy clouds and for the size and number of black
holes. The scalar grade for columnar organization was inversely
associated with the severity of posterior subcapsular and nuclear
cataracts, which was the only feature associated with the LOCS III
grade of ARC. No statistically significant associations were found
between average cell count and LOCS III grade.
conclusions. With the use of the corneal specular microscope excellent in vivo
specular images of the LECs were obtained, the features in these images
that correlated well with microscopic findings were classified, and
cell density in vivo was estimated.
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