Comparison of manual & automated analysis methods for corneal endothelial cell density measurements by specular microscopy

Purpose: To determine the reliability of corneal endothelial cell density (ECD) obtained by automated specular microscopy versus that of validated manual methods and factors that predict such reliability. Methods: Sharp central images from 94 control and 106 glaucomatous eyes were captured with Kona...

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Main Authors: Jianyan Huang, Jyotsna Maram, Tudor C. Tepelus, Cristina Modak, Ken Marion, SriniVas R. Sadda, Vikas Chopra, Olivia L. Lee
Format: Article
Language:English
Published: Elsevier 2018-07-01
Series:Journal of Optometry
Online Access:http://www.sciencedirect.com/science/article/pii/S1888429617300493
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author Jianyan Huang
Jyotsna Maram
Tudor C. Tepelus
Cristina Modak
Ken Marion
SriniVas R. Sadda
Vikas Chopra
Olivia L. Lee
author_facet Jianyan Huang
Jyotsna Maram
Tudor C. Tepelus
Cristina Modak
Ken Marion
SriniVas R. Sadda
Vikas Chopra
Olivia L. Lee
author_sort Jianyan Huang
collection DOAJ
description Purpose: To determine the reliability of corneal endothelial cell density (ECD) obtained by automated specular microscopy versus that of validated manual methods and factors that predict such reliability. Methods: Sharp central images from 94 control and 106 glaucomatous eyes were captured with Konan specular microscope NSP-9900. All images were analyzed by trained graders using Konan CellChek Software, employing the fully- and semi-automated methods as well as Center Method. Images with low cell count (input cells number <100) and/or guttata were compared with the Center and Flex-Center Methods. ECDs were compared and absolute error was used to assess variation. The effect on ECD of age, cell count, cell size, and cell size variation was evaluated. Results: No significant difference was observed between the Center and Flex-Center Methods in corneas with guttata (p = 0.48) or low ECD (p = 0.11). No difference (p = 0.32) was observed in ECD of normal controls <40 yrs old between the fully-automated method and manual Center Method. However, in older controls and glaucomatous eyes, ECD was overestimated by the fully-automated method (p = 0.034) and semi-automated method (p = 0.025) as compared to manual method. Conclusion: Our findings show that automated analysis significantly overestimates ECD in the eyes with high polymegathism and/or large cell size, compared to the manual method. Therefore, we discourage reliance upon the fully-automated method alone to perform specular microscopy analysis, particularly if an accurate ECD value is imperative. Resumen: Objetivo: Determinar la fiabilidad de la densidad celular endotelial corneal (ECD) obtenida mediante microscopio especular automático frente a métodos manuales validados y factores predictivos de la fiabilidad. Métodos: Se capturaron imágenes nítidas de 94 controles y 106 ojos glaucomatosos con un microscopio especular Konan NSP-9900. Todas las imágenes fueron analizadas por examinadores expertos mediante el software Konan CellChek, utilizando los métodos automatizado total, semiautomático y de centrado. Se compararon las imágenes con bajo recuento celular (número de células <100) y/o córnea guttata con el método de centrado y centrado flexible. Se compararon las ECD, utilizándose el error absoluto para valorar la variación. Se evaluó el efecto de la ECD sobre la edad, el recuento celular, el tamaño celular y la variación del tamaño celular. Resultados: No se observó diferencia significativa entre los métodos de centrado y centrado flexible en las córneas con guttata (p = 0,48) o baja ECD (p = 0,11). No se observó diferencia (p = 0,32) en cuanto a ECD en los controles normales < 40 años entre el método totalmente automatizado y el método de centrado manual. Sin embargo, en los controles mayores y en los ojos glaucomatosos, la ECD fue sobreestimada por el método totalmente automatizado (p = 0,034) y el método semiautomático (p = 0,025), en comparación al método manual.Conclusión: Nuestros hallazgos muestran que los análisis automatizados sobreestiman considerablemente la ECD en los ojos con alto polimegatismo y/o gran tamaño celular, en comparación al método manual. Por tanto, no recomendamos confiar en el método totalmente automatizado por sí solo para realizar estudios mediante microscopio especular, particularmente en casos en que la precisión del valor de ECD sea imperativo. Keywords: Corneal endothelial cell density, Automated method, Center Method, Flex-Center Method, Specular microscopy, Palabras clave: Densidad celular endotelial corneal, Método automatizado, Método de centrado, Método de centrado flexible, Microscopio especular
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spelling doaj.art-ad0b09de1afd4a9eb31c66e2c9e084372022-12-22T00:21:26ZengElsevierJournal of Optometry1888-42962018-07-01113182191Comparison of manual & automated analysis methods for corneal endothelial cell density measurements by specular microscopyJianyan Huang0Jyotsna Maram1Tudor C. Tepelus2Cristina Modak3Ken Marion4SriniVas R. Sadda5Vikas Chopra6Olivia L. Lee7Doheny Eye Institute, Los Angeles, CA 90033, United States; Department of Ophthalmology, David Geffen Medical School at UCLA, Los Angeles, CA 90095, United StatesDoheny Eye Institute, Los Angeles, CA 90033, United States; Department of Ophthalmology, David Geffen Medical School at UCLA, Los Angeles, CA 90095, United StatesDoheny Eye Institute, Los Angeles, CA 90033, United States; Department of Ophthalmology, David Geffen Medical School at UCLA, Los Angeles, CA 90095, United StatesDoheny Eye Institute, Los Angeles, CA 90033, United StatesDoheny Eye Institute, Los Angeles, CA 90033, United StatesDoheny Eye Institute, Los Angeles, CA 90033, United States; Department of Ophthalmology, David Geffen Medical School at UCLA, Los Angeles, CA 90095, United StatesDoheny Eye Institute, Los Angeles, CA 90033, United States; Department of Ophthalmology, David Geffen Medical School at UCLA, Los Angeles, CA 90095, United StatesDoheny Eye Institute, Los Angeles, CA 90033, United States; Department of Ophthalmology, David Geffen Medical School at UCLA, Los Angeles, CA 90095, United States; Corresponding author at: 800S Fairmount Ave Suite 215, Pasadena, CA 91105, United States.Purpose: To determine the reliability of corneal endothelial cell density (ECD) obtained by automated specular microscopy versus that of validated manual methods and factors that predict such reliability. Methods: Sharp central images from 94 control and 106 glaucomatous eyes were captured with Konan specular microscope NSP-9900. All images were analyzed by trained graders using Konan CellChek Software, employing the fully- and semi-automated methods as well as Center Method. Images with low cell count (input cells number <100) and/or guttata were compared with the Center and Flex-Center Methods. ECDs were compared and absolute error was used to assess variation. The effect on ECD of age, cell count, cell size, and cell size variation was evaluated. Results: No significant difference was observed between the Center and Flex-Center Methods in corneas with guttata (p = 0.48) or low ECD (p = 0.11). No difference (p = 0.32) was observed in ECD of normal controls <40 yrs old between the fully-automated method and manual Center Method. However, in older controls and glaucomatous eyes, ECD was overestimated by the fully-automated method (p = 0.034) and semi-automated method (p = 0.025) as compared to manual method. Conclusion: Our findings show that automated analysis significantly overestimates ECD in the eyes with high polymegathism and/or large cell size, compared to the manual method. Therefore, we discourage reliance upon the fully-automated method alone to perform specular microscopy analysis, particularly if an accurate ECD value is imperative. Resumen: Objetivo: Determinar la fiabilidad de la densidad celular endotelial corneal (ECD) obtenida mediante microscopio especular automático frente a métodos manuales validados y factores predictivos de la fiabilidad. Métodos: Se capturaron imágenes nítidas de 94 controles y 106 ojos glaucomatosos con un microscopio especular Konan NSP-9900. Todas las imágenes fueron analizadas por examinadores expertos mediante el software Konan CellChek, utilizando los métodos automatizado total, semiautomático y de centrado. Se compararon las imágenes con bajo recuento celular (número de células <100) y/o córnea guttata con el método de centrado y centrado flexible. Se compararon las ECD, utilizándose el error absoluto para valorar la variación. Se evaluó el efecto de la ECD sobre la edad, el recuento celular, el tamaño celular y la variación del tamaño celular. Resultados: No se observó diferencia significativa entre los métodos de centrado y centrado flexible en las córneas con guttata (p = 0,48) o baja ECD (p = 0,11). No se observó diferencia (p = 0,32) en cuanto a ECD en los controles normales < 40 años entre el método totalmente automatizado y el método de centrado manual. Sin embargo, en los controles mayores y en los ojos glaucomatosos, la ECD fue sobreestimada por el método totalmente automatizado (p = 0,034) y el método semiautomático (p = 0,025), en comparación al método manual.Conclusión: Nuestros hallazgos muestran que los análisis automatizados sobreestiman considerablemente la ECD en los ojos con alto polimegatismo y/o gran tamaño celular, en comparación al método manual. Por tanto, no recomendamos confiar en el método totalmente automatizado por sí solo para realizar estudios mediante microscopio especular, particularmente en casos en que la precisión del valor de ECD sea imperativo. Keywords: Corneal endothelial cell density, Automated method, Center Method, Flex-Center Method, Specular microscopy, Palabras clave: Densidad celular endotelial corneal, Método automatizado, Método de centrado, Método de centrado flexible, Microscopio especularhttp://www.sciencedirect.com/science/article/pii/S1888429617300493
spellingShingle Jianyan Huang
Jyotsna Maram
Tudor C. Tepelus
Cristina Modak
Ken Marion
SriniVas R. Sadda
Vikas Chopra
Olivia L. Lee
Comparison of manual & automated analysis methods for corneal endothelial cell density measurements by specular microscopy
Journal of Optometry
title Comparison of manual & automated analysis methods for corneal endothelial cell density measurements by specular microscopy
title_full Comparison of manual & automated analysis methods for corneal endothelial cell density measurements by specular microscopy
title_fullStr Comparison of manual & automated analysis methods for corneal endothelial cell density measurements by specular microscopy
title_full_unstemmed Comparison of manual & automated analysis methods for corneal endothelial cell density measurements by specular microscopy
title_short Comparison of manual & automated analysis methods for corneal endothelial cell density measurements by specular microscopy
title_sort comparison of manual automated analysis methods for corneal endothelial cell density measurements by specular microscopy
url http://www.sciencedirect.com/science/article/pii/S1888429617300493
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