Studying hypertension in ocular fundus images using Hausdorff dispersion ordering.
Retinal arterial and vein diameters are altered in individuals at risk of cardiovascular events mainly due to high blood pressure. The measurement of retinal vessel diameters has been proved to reflect individuals' vascular health. Dispersion of such measures which are obtained by means of ocular fundus images is a major factor not usually considered in clinical research. In this paper, a method to evaluate if different levels of clinically relevant covariables induce greater dispersion in retinal arterial and vein diameters is proposed. A multivariate dispersion ordering, the Hausdorff dispersion order, is used to compare the level of dispersion in such diameters for different groups of pa…
A granulometric analysis of specular microscopy images of human corneal endothelia
The inner layer of the human cornea, called the corneal endothelium, plays an important role in the maintenance of corneal transparency. Specular microscopy is the most widely used technique to study the corneal endothelium in vivo. Improvements in technology have allowed us to obtain good quality specular images, but the detection and quantification of small size-shape cell changes is not obvious, specially when the physician wants to evaluate endothelial cell changes after some surgical procedures. This paper proposes a methodology to analyze specular microscopy images. Every corneal endothelium is described by means of different cumulative distribution functions or some moments (mean, st…
Macular edema computer-aided evaluation in ocular vein occlusions.
This paper is concerned with the use of digital fundus imaging to detect, quantify, and follow up macular angiographic leakage due to retinal vein occlusions. Images were matched automatically. We detected those pixels with a high increment in gray level within the closest area to the foveal center. Binary images displaying leakage were obtained. The procedure was checked against two observers' agreement. Twenty-one angiographic studies were collected. Two images of each sequence were selected for digitalization. Numerical descriptors of the leakage were proposed and quantification plots were designed for each pair of images. Interobserver concordance ranged between 82 and 98% when manually…
Granulometric moments and corneal endothelium status
Abstract Specular microscopy is a common practice in Ophthalmology. The corneal endothelium status is usually evaluated by means of the density, the hexagonality, the mean, the standard deviation and the coefficient of variation of cell areas. We propose to replace the cell area moments by the corresponding moments of a different probability distribution, the granulometric size distribution associated to a disc. All cells touching the frame are ignored by the area moments but used by the granulometric moments. Twenty images have been analyzed. When the size of the focused region is reduced, the area moments show a greater variation than the corresponding granulometric moments.
Preoperative factors influencing success in pterygium surgery
Abstract Background To identify preoperative, perioperative and postoperative risk factors that influence the success of pterygium surgery. Methods This is a prospective study of thirty-six patients with primary or recurrent pterygia. A detailed anamnesis and an ophthalmological examination were performed looking for the following factors: age, race, latitude and altitude of the main place of residence, hours of exposure to the sun, use of protective measures against UV-radiation, classification of pterygium, width of the pterygium at limbus, surgical technique (conjunctival autograft plus suturing versus tissue glue), graft alterations (misapposition, granuloma, haemorrhage, oedema, retrac…
Semi-automated evaluation tool for retinal vasculopathy.
The ocular fundus is the only area of human body where vascular system is visible using relatively simple instrumentation. Furthermore, there is medical suggestive evidence of a direct relationship between certain measures of vascular characteristics in the ocular fundus (arteriolar and venular calibers and focal arteriolar narrowing) and cardiovascular diseases. In order to establish such relationship on sound statistical basis a method must be provided to measure the needed values in an easy, yet precise and repeatable way. This paper presents a system to assist physicians in signaling and storing the data associated to signs of vascular deterioration and vascular calibers in non-mydriati…
Testing abnormality in the spatial arrangement of cells in the corneal endothelium using spatial point processes
The study of central corneal endothelium morphology is important in Ophthalmology. Some of the pathologies that could compromise endothelial cell morphology are trauma, cataract, surgery, use of contact lenses, corneal dystrophies or degenerations. The quantitative analysis of cell shape and cellular pattern is more sensitive in detecting subtle changes in endothelial morphology than cell density measurement or cell area analysis. In this paper, the morphology of the central cornea, the most important area from the point of view of vision, is studied through an associated bivariate spatial point pattern: the centroids of the cells and the triple points, that is, the points where three diffe…
Classifying human endothelial cells based on individual granulometric size distributions
Abstract This paper presents an application to a medical problem of methods of shape analysis based on mathematical morphology. The medical problem consists on the detection of abnormalities in the corneal endothelium, a tissue composed by quasi-planar cells of ideally regular hexagonal shape. Images of this tissue are taken by a specular microscope and used to evaluate the corneal endothelium status. Up to now, cell density, hexagonality and an analysis of cell areas are the usual descriptors of a corneal endothelium. These parameters are not sensitive enough to detect subtle lesions. What this paper proposes is an analysis based on granulometries, which are size-shape descriptors widely u…
Granulometric analysis of corneal endothelium specular images by using a germ–grain model
Specular microscopy is widely used to study the human corneal endothelium status in vivo. In this paper, the corneal endothelium is represented as a binary image composed of the cell inscribed circles. The granulometric distribution function of the complement of this image is used as a functional descriptor, which provides information about the shape, size and spatial arrangement of cells. Experimental evaluation using bootstrap techniques shows its ability to discriminate between controls and pathological cases. It represents a reliable and graphical alternative to the classical indices (cell density, hexagonality and coefficient of variation of cell areas), which behave poorly when detect…
Fungal Necrotizing Scleritis After Intravitreal Injection Therapy
PURPOSE To report a case of infectious necrotizing scleritis secondary to Aspergillus terreus after intravitreal injection therapy. METHODS This is a case report with literature review. RESULTS A 98-year-old woman receiving intravitreal aflibercept injections for neovascular age-related macular degeneration in the left eye presented with severe pain, redness, and purulent discharge at the injection site. She was initially treated with topical fortified antibiotics, and clinical improvement was achieved, although microbial cultures showed negative results. Two months later, she presented with severe ocular pain and was diagnosed with anterior necrotizing scleritis. Scleral scrapings were col…
Irregular motion recovery in fluorescein angiograms
Abstract Fluorescein angiography is a common procedure in ophthalmic practice, mainly to evaluate vascular retinopathies and choroidopathies from sequences of ocular fundus images. In order to compare the images, a reliable overlying is essential. This paper proposes some methods for the recovery of irregular motion in fluorescein angiograms (FA). The overlying is done by a three step procedure: detection of relevant points, matching points from different images and estimation of the assumed linear geometric transformation. A stochastic model (closely related to the general linear model) allows to fuse the second and third steps. Two different estimators of the geometric transformation are …