Measurement area and repeatability of semiautomated assessment of corneal endothelium in the Topcon specular microscope SP-2000P and IMAGEnet system.

PURPOSE: To investigate the repeatability of the semiautomatic assessment of corneal endothelial cells and its association with the measurement area in the Topcon SP-2000P microscope and IMAGEnet system. METHODS: Specular microscopic images of 86 healthy subjects were captured and analyzed using the Topcon SP-2000P microscope and IMAGEnet system. The same images were analyzed twice, on separate days, by the same examiner using the built-in measurement tool of the IMAGEnet system. The measurement areas were defined with a frame mounted on a computer screen. Four different-sized measurement areas were chosen for the semiautomatic measurements: box A (5.4 × 13.9 cm(2)), box B (4 × 10 cm(2)), box C (4 × 7 cm(2)), and box D (2 × 5 cm(2)). Average cell size (ACS), endothelial cell density (ECD), coefficient of variance, and hexagonality were measured. Repeatability was assessed based on the limit of agreement (LOA). RESULTS: The means of ACS, ECD, and hexagonality were not statistically different across 4 measurement areas (analysis of variance, P > 0.05). The mean differences (bias) were modest for ACS (range, -1.9∼3.9 µm(2)), ECD (range, -27.2∼14.6 cells per square millimeter), coefficient of variance (range, -0.14∼1.00), and hexagonality (range, -1.3%∼6.8%). Limits of agreement (mean difference ± 1.96× SD) were greater in the measurements with smaller areas: limit of agreement values for ECD were 14.6 ± 99.6, -3.8 ± 101.1, -27.2 ± 179, and -15.8 ± 488 cells per square millimeter for boxes A, B, C, and D, respectively. Similar trends were found in the repeatability of ACS and hexagonality. CONCLUSIONS: Repeatability is improved when larger measurement areas are chosen.

Qualitative assessment of ultrasound biomicroscopic images using standard photographs: the liwan eye study.

Objective. To classify anatomic features related to anterior chamber angles by a qualitative assessment system based on ultrasound biomicroscopy (UBM) images. Methods. Cases of primary angle-closure suspect (PACS), defined by pigmented trabecular meshwork that is not visible in two or more quadrants on static gonioscopy (cases) and systematically selected subjects (1 of every 10) who did not meet this criterion (controls) were enrolled during a population-based survey in Guangzhou, China. All subjects underwent UBM examination. A set of standard UBM images was used to qualitatively classify anatomic features related to the angle configuration, including iris thickness, iris convexity, iris angulation, ciliary body size, and ciliary process position. All analysis was conducted on right eye images. Results. Based on the qualitative grades, the difference in overall iris thickness between gonioscopically narrow eyes (n = 117) and control eyes (n = 57) was not statistically significant. The peripheral one third of the iris tended to be thicker in all quadrants of the PACS eyes, although the difference was statistically significant only in the superior quadrant (P = 0.008). No significant differences were found in the qualitative classifications of iris insertion, iris angulation, ciliary body size, and ciliary process position. The findings were similar when compared with the control group of eyes with wide angles in all quadrants. Conclusions. Basal iris thickness seems to be more relevant to narrow angle configuration than to overall iris thickness. Otherwise, the anterior rotation and size of the ciliary body, the iris insertion, and the overall iris thickness are comparable in narrow- and wide-angle eyes.