Assessing Fuchs Corneal Endothelial Dystrophy Using Artificial Intelligence-Derived Morphometric Parameters From Specular Microscopy Images

Purpose: The aim of this study was to evaluate the efficacy of artificial intelligence–derived morphometric parameters in characterizing Fuchs corneal endothelial dystrophy (FECD) from specular microscopy images. Methods: This cross-sectional study recruited patients diagnosed with FECD, who underwent ophthalmologic evaluations, including slit-lamp examinations and corneal endothelial assessments using specular microscopy. The modified Krachmer grading scale was used for clinical FECD classification. The images were processed using a convolutional neural network for segmentation and morphometric parameter estimation, including effective endothelial cell density, guttae area ratio, coefficient of variation of size, and hexagonality. A mixed-effects model was used to assess relationships between the FECD clinical classification and measured parameters. Results: Of 52 patients (104 eyes) recruited, 76 eyes were analyzed because of the exclusion of 26 eyes for poor quality retroillumination photographs. The study revealed significant discrepancies between artificial intelligence–based and built-in microscope software cell density measurements (1322 ± 489 cells/mm2 vs. 2216 ± 509 cells/mm2, P < 0.001). In the central region, guttae area ratio showed the strongest correlation with modified Krachmer grades (0.60, P < 0.001). In peripheral areas, only guttae area ratio in the inferior region exhibited a marginally significant positive correlation (0.29, P < 0.05). Conclusions: This study confirms the utility of CNNs for precise FECD evaluation through specular microscopy. Guttae area ratio emerges as a compelling morphometric parameter aligning closely with modified Krachmer clinical grading. These findings set the stage for future large-scale studies, with potential applications in the assessment of irreversible corneal edema risk after phacoemulsification in FECD patients, as well as in monitoring novel FECD therapies.

• Autores: Prada, Angelica M.; Quintero, Fernando; Mendoza, Kevin; Galvis, Virgilio; Tello, Alejandro; Romero, Lenny A; Marrugo, Andres G.
• Fecha de publicación: 2024
• Institución: Universidad Tecnológica de Bolívar
• Repositorio: Repositorio Institucional UTB
• Idioma: eng
• OAI Identifier: oai:repositorio.utb.edu.co:20.500.12585/12706
• Acceso en línea: https://hdl.handle.net/20.500.12585/12706
• Palabra clave: Fuchs dystrophy; Specular microscopy; Endothelial cell density; Artificial intelligence,; Deep learning; LEMB
• Rights: openAccess
• License: http://creativecommons.org/licenses/by-nc-nd/4.0/