Automatic segmentation of corneal dystrophy on photographic images based on texture analysis.

PURPOSE: To develop an automatic algorithm to analyze dystrophic lesions on photographic images of corneal dystrophy. METHODS: The dataset included 32 images of corneal dystrophy. The dystrophic area was manually segmented twice. Manually labeled dystrophy areas were compared with automatically segmented images. First, we manually removed the light reflex from the image of the cornea. Using an automatic approach, we extracted the brown color of the iris. Then, the program detected the circular region of the pupil and the corneal surface. A whitish dystrophy area was defined based on the image intensity on the iris and the pupil. The sliding square kernel was applied to clearly define the dystrophic region. RESULTS: For the manual analysis and the twice automatic approach, the Dice similarity was 0.804 and 0.801, respectively. The Pearson correlation coefficient was 0.807 and 0.806, respectively. The total number of distinct dystrophic areas showed no significant difference between the manual and automatic approaches according to the Wilcoxon signed-rank test (p < 0.0001, both). CONCLUSIONS: We proposed an automatic algorithm for detecting the dystrophy areas on photographic images with an accuracy of approximately 0.80. This system can be applied to detect and predict the progression of corneal dystrophy.

GAP IN CAPILLARY PERFUSION AND BURDEN OF TREATMENT IN BRANCH RETINAL VEIN OCCLUSION: A Wide-Field Optical Coherence Tomography Angiography Study.

PURPOSE: To evaluate correlations between the burden of antivascular endothelial growth factor treatment and microperfusion status in superficial capillary plexus and deep capillary plexus (SCP and DCP) using wide-field optical coherence tomography angiography. METHODS: A total 19 eyes with branch retinal vein occlusion were included in this retrospective study. Area of foveal avascular zone, capillary nonperfusion area, vascular density, and perfusion gap were compared between superficial capillary plexus and DCP. Internal areas of 3, 6, and 12 mm in diameter around the fovea were analyzed separately. RESULTS: The mean number of injections per months was 0.20 ± 0.12. The number of antivascular endothelial growth factor injections per month showed a significant correlation with perfusion gap in 12 mm area (P = 0.010), but not with perfusion gap in 3-mm or 6-mm area. Correlations were also found between the final best-corrected visual acuity and vascular density in the 12 mm area of DCP (P = 0.031) and foveal avascular zone area (P = 0.033). CONCLUSION: Wide-field optical coherence tomography angiography is very useful for assessing the microperfusion status in branch retinal vein occlusion. In extended field of view (12 mm × 12 mm), a larger perfusion gap was associated with frequent requirements of antivascular endothelial growth factor injections for macular edema. Reduction in vessel density was significantly correlated with poor visual outcome.

Oral-Facial-Digital Syndrome Type IX with Subfoveal Drusenoid Deposit.

We describe a patient with oral-facial-digital syndrome (OFDS) with the following anomalies: cleft lip, cleft palate, micrognathia, hypertelorism, nasal septum deviation, thumb polydactyly in the right hand, and partial agenesis of the corpus callosum. In addition, the patient had optic disc coloboma in the left eye and subfoveal drusenoid deposit in the right eye, features of OFDS type IX. Subfoveal drusenoid deposit has not been previously reported in OFDS type IX. Evaluation of the fundus is necessary for diagnosis of OFDS.