Automated analysis of corneal endothelial cell morphology

Specular microscopy permits in vivo quantitative morphometric analysis of the corneal endothelium. Cell density and shape correlate closely with the ability of the corneal endothelium to dehydrate the corneal stroma and maintain the clarity of the cornea. Most investigators use manual cell tracing to obtain cell boundaries. The tedious tracing process may be facilitated using a planimeter and digitizer but it is quite subjective. Several papers have reported successful automation of corneal endothelial cell morphometric analysis using contact specular microscopy1'2'3'4. Non—contact specular microscopy has been more difficult to automate because of tear-film and epithelial cell reflections5. The non-contact specular image has a strong background gray scale gradient, low contrast, thick boundaries, and considerable extraneous nonboundary structure. The objective of this research was to develop an automated corneal endothelial cell morphometric analysis of images obtained by non-contact specular microscopy, and to compare the results obtained by the automated technique with manual cell tracing for speed and accuracy.