June 2015
Volume 56, Issue 7
Free
ARVO Annual Meeting Abstract  |   June 2015
Automated, software-based objective assessment of Fuchs Corneal Dystrophy severity utilizing retroillumination photography analysis
Author Affiliations & Notes
  • Allen O Eghrari
    Wilmer Eye Institute, Johns Hopkins Hospital, Baltimore, MD
  • Brian Garrett
    Wilmer Eye Institute, Johns Hopkins Hospital, Baltimore, MD
  • Aisha Mumtaz
    Wilmer Eye Institute, Johns Hopkins Hospital, Baltimore, MD
  • Elyse Joelle McGlumphy
    Wilmer Eye Institute, Johns Hopkins Hospital, Baltimore, MD
  • Benjamin W. Iliff
    Wilmer Eye Institute, Johns Hopkins Hospital, Baltimore, MD
  • Armand Edalati
    Wilmer Eye Institute, Johns Hopkins Hospital, Baltimore, MD
  • S. Amer Riazuddin
    Wilmer Eye Institute, Johns Hopkins Hospital, Baltimore, MD
  • John D Gottsch
    Wilmer Eye Institute, Johns Hopkins Hospital, Baltimore, MD
  • Footnotes
    Commercial Relationships Allen Eghrari, None; Brian Garrett, None; Aisha Mumtaz, None; Elyse McGlumphy, None; Benjamin Iliff, None; Armand Edalati, None; S. Amer Riazuddin, None; John Gottsch, None
  • Footnotes
    Support None
Investigative Ophthalmology & Visual Science June 2015, Vol.56, 1640. doi:
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      Allen O Eghrari, Brian Garrett, Aisha Mumtaz, Elyse Joelle McGlumphy, Benjamin W. Iliff, Armand Edalati, S. Amer Riazuddin, John D Gottsch; Automated, software-based objective assessment of Fuchs Corneal Dystrophy severity utilizing retroillumination photography analysis. Invest. Ophthalmol. Vis. Sci. 2015;56(7 ):1640.

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      © ARVO (1962-2015); The Authors (2016-present)

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Abstract
 
Purpose
 

Retroillumination photography analysis (RPA) is an objective tool for assessment of the number and distribution of guttae in eyes affected with Fuchs Corneal Dystrophy (FCD). RPA provides a distinct baseline of 0 guttae, in contrast to variable baseline measurements of pachymetry, and can provide high resolution of disease progression. Current protocols include manual processing of images; here we demonstrate a software-based system for automated analysis across various levels of FCD severity.

 
Methods
 

Retroillumination photographs of ten FCD-affected corneas across various levels of severity were acquired and total counts of guttae summated manually using methods we have previously described. For each cornea, a single image was then loaded into ImageJ software. Processing included reducing color variability and subtracting background noise. Reflection of light from each gutta was identified as a local area of maximum intensity and counted automatically. Background irregularities due to lenticular or tear film abnormalities specific to each individual were adjusted by titrating noise tolerance levels to each cornea. Quality control was conducted by examining a small region of each image with automated overlay to ensure appropriate coverage of individual guttae.

 
Results
 

A total of ten retroillumination photographs were analyzed. The Krachmer score, a 1-to-5 grading scale assigned clinically through slit-lamp biomicroscopy, ranged from a severity level of 2 to 5 in the set of analyzed corneas, consistent with mild to severe disease. Automated counts demonstrated a strong linear correlation with manual counts in the set of images (R2=0.93) , each of which ranged from 189 to 9211 guttae.

 
Conclusions
 

Software-based, automated RPA allows for rapid grading of FCD severity with high resolution across mild, moderate, and advanced levels of disease severity. This technique may prove beneficial for clinical trials which require precise characterization of disease severity using efficient methods.  

 
Retroillumination photograph of a cornea affected by Fuchs Corneal Dystrophy. Guttae, excrescences of Descemet membrane, are appreciated centrally.
 
Retroillumination photograph of a cornea affected by Fuchs Corneal Dystrophy. Guttae, excrescences of Descemet membrane, are appreciated centrally.

 
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