title: Morphometric Analyses by a New Slit-Lamp Endothelial Biomicroscope.
abstract: OBJECTIVE
  A method called EndoKer was recently devised for the morphometric analysis of the cell mosaic of the corneal endothelium. Fully automatic cell recognition is performed on images acquired by a slit-lamp biomicroscope. The aim of this study was to evaluate the accuracy of the EndoKer results.
  
  
  METHODS
  Analyses were performed on a polystyrene bead layer stratified on a contact lens and in vivo on 30 adults. Accuracy was evaluated by comparing the results of EndoKer with the true values obtained by manual counting of the cells in the same images. EndoKer results were also compared with those obtained with the Tomey EM3000 microscope.
  
  
  RESULTS
  The accuracy of the results compared with the manual counting on the same images showed a difference of a few percent for the cell density and for hexagonality. This high accuracy derives from (1) the resolution of the slit-lamp images and (2) the improved cell recognition of the fully automatic method. A good agreement was also found between EndoKer and the Tomey EM3000 microscope results.
  
  
  CONCLUSIONS
  Based on the investigated 30 cases, the slit-lamp biomicroscope may be a viable alternative to dedicated endothelial instruments, providing the additional advantages of a larger investigated area and the possibility to take images of different portions of the cornea. The calibration was performed during the development of the method by using polystyrene beads. The user is not required to perform this calibration. However, such a calibrated sample is suggested for those interested.
authors.affiliation: *Department of Materials Science, University of Milano-Bicocca, Milan, Italy; †University of Milano-Bicocca, COMiB, Milan, Italy; ‡National Interuniversity Consortium of Materials Science and Technology INSTM, Florence, Italy; and §ASST Fatebenefratelli-Sacco, Milan, Italy.
authors.forename: Lorenzo
authors.initials: L
authors.lastname: Ferraro
authors.forename: Federica
authors.initials: F
authors.lastname: Cozza
authors.forename: Antonio
authors.initials: A
authors.lastname: Scialdone
authors.forename: Alessandro
authors.initials: A
authors.lastname: Borghesi
authors.forename: Silvia
authors.initials: S
authors.lastname: Tavazzi
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002138:Calibration; D002452:Cell Count; D004728:Endothelium, Corneal / Q000166:cytology*; D005260:Female; D006801:Humans; D007091:Image Processing, Computer-Assisted; D008297:Male; D008863:Microspheres; D008875:Middle Aged; D011137:Polystyrenes; D015203:Reproducibility of Results; D066167:Slit Lamp; D055815:Young Adult
chemical_list: D011137:Polystyrenes