Abstract
Purpose
To evaluate two specular microscopy analysis methods across different endothelial cell densities (ECDs).
Methods
Endothelial images of one eye from each of 45 patients were taken by using three different specular microscopes (three replicates each). To determine the consistency of the center-dot method, we compared SP-6000 and SP-2000P images. CME-530 and SP-6000 images were compared to assess the consistency of the fully automated method. The SP-6000 images from the two methods were compared. Intraclass correlation coefficients (ICCs) for the three measurements were calculated, and parametric multiple comparisons tests and Bland–Altman analysis were performed.
Results
The ECD mean value was 2425 ± 883 (range 516–3707) cells/mm2. ICC values were > 0.9 for all three microscopes for ECD, but the coefficients of variation (CVs) were 0.3–0.6. For ECD measurements, Bland–Altman analysis revealed that the mean difference was 42 cells/mm2 between the SP-2000P and SP-6000 for the center-dot method; 57 cells/mm2 between the SP-6000 measurements from both methods; and −5 cells/mm2 between the SP-6000 and CME-530 for the fully automated method (95% limits of agreement: − 201 to 284 cell/mm2, − 410 to 522 cells/mm2, and − 327 to 318 cells/mm2, respectively). For CV measurements, the mean differences were − 3, − 12, and 13% (95% limits of agreement − 18 to 11, − 26 to 2, and − 5 to 32%, respectively).
Conclusions
Despite using three replicate measurements, the precision of the center-dot method with the SP-2000P and SP-6000 software was only ± 10% for ECD data and was even worse for the fully automated method.
Clinical trial registration
Japan Clinical Trials Register (http://www.umin.ac.jp/ctr/index/htm9) number UMIN 000015236.
Similar content being viewed by others
References
Maurice DM, Giardini AA (1951) Swelling of the cornea in vivo after the destruction of its limiting layers. Br J Ophthalmol 35:791–797
Bonanno JA (2003) Identity and regulation of iron transport mechanisms in the corneal endothelium. Prog Retin Eye Res 22:69–94
Kim SY, Park YH, Lee YC (2008) Comparison of the effect of intracameral moxifoxacin, levofloxacin and cefazolin on rabbit corneal endothelial cells. Clin Exp Ophthalmol 36:367–370
McCarey BE, Edelhauser HF, Lynn MJ (2008) Review of corneal endothelial specular microscopy for FDA clinical trial of refractive procedures, surgical devices, and new intraocular drugs and solutions. Cornea 27:1–16
Edelhauser HF (2000) The resiliency of the corneal endothelium to refractive and intraocular surgery. Cornea 19:263–273
Eszter S, Gabor N, Andras B, Laszlo M (2011) Evaluation of the corneal endothelium using noncontact and contact specular microscopy. Cornea 30:567–570
The American Academy of Ophthalmology (2017) Task force recommendations for specular microscopy for phakic intraocular lenses. Ophthalmology 124:141–142
Doughty MJ, Muller A, Zaman ML (2000) Assessment of the reliability of human corneal endothelial cell-density estimates using a noncontact specular microscope. Cornea 19:148–158
Goldich Y, Marcovich AL, Barkana Y, Hartstein M, Morad Y, Avnil I et al (2010) Comparison of corneal endothelial cell density estimated with 2 noncontact specular microscopes. Eur J Ophthalmol 20:825–830
Cheung SW, Cho P (2000) Endothelial cells analysis with the TOPCON specular microscope SP-2000P and IMAGEnet system. Curr Eye Res 21:788–798
Doughty MJ (2013) Evaluation of possible error sources in corneal endothelial morphometry with a semiautomated noncontact specular microscope. Cornea 32:1196–1203
Thuret G, Deb-Joardar N, Zhao M, Gain P, Gavet Y, Nguyen F (2007) Agreement between two non-contact specular microscopes: Topcon SP-2000P versus Rhine-Tec. Br J Ophthalmol 91:979–980
Nikolaus L, Nino H, Sandra S, Petra D, Oliver F (2015) Comparison of 4 specular microscopes in healthy eyes and eyes with cornea guttata or corneal grafts. Cornea 34:381–386
Marianne OP, Kelly MF, Francis WP (2013) Comparison of manual and automated endothelial cell density analysis in normal eyes and DSEK eyes. Cornea 32:567–573
Bland JM, Altman DG (1986) Statistical methods for assessing agreement between two methods of clinical measurement. Lancet 1:307–310
Bland JM, Altman DG (1999) Measuring agreement in method comparison studies. Stat Methods Med Res 8:135–160
Vecchi M, Braccio L, Orsoni JG (1996) The Topcon SP 1000 and Image-NET system: a comparison of four methods for evaluating corneal endothelial cell density. Cornea 15:271–277
de Sanctis Ugo, Federica M, Luca R, Paola D, Federico M (2006) Corneal endothelium evaluation with 2 noncontact specular microscopes and their semiautomated methods of analysis. Cornea 25:501–506
Willem S, Bart THD, Paul GHM, Hennie JMV (2005) Validity of endothelial cell analysis methods and recommendations for calibration in Topcon SP-2000p specular microscopy. Cornea 24:538–544
Acknowledgements
The authors thank Hajime Yamakage for his advice on the statistical analyses performed in this study.
Author information
Authors and Affiliations
Contributions
Authors’ contributions
S.M., S.N., C.K., H.T., T.C., and Y.K. were involved in designing the study. S.M., N.M., and K.Y. conducted the study. S.M., and S.N. statistically analyzed the results of the study and all authors gave their final approval of the article for submission.
Corresponding author
Ethics declarations
Conflict of interest
The authors declare that they have no conflict of interests.
Rights and permissions
About this article
Cite this article
Maruoka, S., Nakakura, S., Matsuo, N. et al. Comparison of semi-automated center-dot and fully automated endothelial cell analyses from specular microscopy images. Int Ophthalmol 38, 2495–2507 (2018). https://doi.org/10.1007/s10792-017-0760-7
Received:
Accepted:
Published:
Issue Date:
DOI: https://doi.org/10.1007/s10792-017-0760-7