June 2022
Volume 63, Issue 7
Open Access
ARVO Annual Meeting Abstract  |   June 2022
Automated processing of images obtained by anterior segment fluorescence imaging device: evaluating dry eye
Author Affiliations & Notes
  • Jonghwa Kim
    Ophthalmology, Chonnam National University Hospital, Gwangju, Gwangju, Korea (the Republic of)
  • Tae Joong Eom
    Advanced Photonics Research Institute, Gwangju Institute of Science and Technology, Gwangju, Korea (the Republic of)
  • HYEON JEONG YOON
    Ophthalmology, Chonnam National University Hospital, Gwangju, Gwangju, Korea (the Republic of)
  • Eunwoo Park
    Advanced Photonics Research Institute, Gwangju Institute of Science and Technology, Gwangju, Korea (the Republic of)
  • Kyung Chul Yoon
    Ophthalmology, Chonnam National University Hospital, Gwangju, Gwangju, Korea (the Republic of)
  • Footnotes
    Commercial Relationships   Jonghwa Kim None; Tae Joong Eom None; HYEON JEONG YOON None; Eunwoo Park None; Kyung Chul Yoon None
  • Footnotes
    Support  None
Investigative Ophthalmology & Visual Science June 2022, Vol.63, 218 – F0065. doi:
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      Jonghwa Kim, Tae Joong Eom, HYEON JEONG YOON, Eunwoo Park, Kyung Chul Yoon; Automated processing of images obtained by anterior segment fluorescence imaging device: evaluating dry eye. Invest. Ophthalmol. Vis. Sci. 2022;63(7):218 – F0065.

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

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Abstract

Purpose : Clinical examination of dry eye patients may yield different results according to the examiners. We aimed to invent a fluorescence anterior segment imaging device using blue light LED (490 nm wavelength) light source and automated image processing system that analyzes acquired video images so that we can obtain a diagnostic index for dry eye by measuring the temporal change of the fluorescence signal.

Methods : We developed an anterior segment fluorescence imaging device consisting of an LED light source of 490 nm wavelength and a filter that selectively transmits only the fluorescence signal to measure the fluorescence signal change in the corneal lesion and tear film after topically applying fluorescein sodium.
In order to measure the change in the tear meniscus height (TMH), a fixed region of interest independent of eye movement was chosen and the height of tear meniscus in the region was measured.
In order to measure the tear film break-up time (TBUT), we obtained changes in fluorescence signal area in the cornea between blinking and processed the video images automatically. The point of tear film break-up was provisionally set as the point at which non-fluorescence area increased by 0.5%.
In order to measure the corneal staining score (CSS), the punctate points in the cornea that did not change in fluorescence temporally were extracted. The scoring was done according to the Oxford grading scale.
To test the reliability of the device, TMH, TBUT and CSS of 80 eyes of volunteers were measured by Keratograph 5M (OCULUS Inc., Wetzlar, Germany) and by slit-lamp biomicroscopy examined by a cornea expert.

Results : The images obtained with the newly developed device showed tear film break-up pattern, TBUT, TMH, and CSS similar to the images obtained with a video capture system in a slit-lamp biomicroscopy using cobalt-blue filter and the images obtained with keratograph 5M. The correlation coefficient showed highly reliable results for TBUT, TMH and CSS (all>0.8)

Conclusions : The LED-based anterior segment fluorescence imaging device with automatic analysis program is a useful tool for measuring dry eye indices and can yield precise results. By further applying a deep learning system, the program would even be able suggest treatment strategies.

This abstract was presented at the 2022 ARVO Annual Meeting, held in Denver, CO, May 1-4, 2022, and virtually.

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