scholarly journals A deep transfer learning framework for the automated assessment of corneal inflammation on in vivo confocal microscopy images

PLoS ONE ◽  
2021 ◽  
Vol 16 (6) ◽  
pp. e0252653
Author(s):  
Fan Xu ◽  
Yikun Qin ◽  
Wenjing He ◽  
Guangyi Huang ◽  
Jian Lv ◽  
...  
Keyword(s):  
Dendritic Cells ◽  
Confocal Microscopy ◽  
Transfer Learning ◽  
Inflammatory Cells ◽  
Computer Assisted ◽  
In Vivo Confocal Microscopy ◽  
Learning Models ◽  
Corneal Inflammation ◽  
Microscopy Images

Purpose Infiltration of activated dendritic cells and inflammatory cells in cornea represents an important marker for defining corneal inflammation. Deep transfer learning has presented a promising potential and is gaining more importance in computer assisted diagnosis. This study aimed to develop deep transfer learning models for automatic detection of activated dendritic cells and inflammatory cells using in vivo confocal microscopy images. Methods A total of 3453 images was used to train the models. External validation was performed on an independent test set of 558 images. A ground-truth label was assigned to each image by a panel of cornea specialists. We constructed a deep transfer learning network that consisted of a pre-trained network and an adaptation layer. In this work, five pre-trained networks were considered, namely VGG-16, ResNet-101, Inception V3, Xception, and Inception-ResNet V2. The performance of each transfer network was evaluated by calculating the area under the curve (AUC) of receiver operating characteristic, accuracy, sensitivity, specificity, and G mean. Results The best performance was achieved by Inception-ResNet V2 transfer model. In the validation set, the best transfer system achieved an AUC of 0.9646 (P<0.001) in identifying activated dendritic cells (accuracy, 0.9319; sensitivity, 0.8171; specificity, 0.9517; and G mean, 0.8872), and 0.9901 (P<0.001) in identifying inflammatory cells (accuracy, 0.9767; sensitivity, 0.9174; specificity, 0.9931; and G mean, 0.9545). Conclusions The deep transfer learning models provide a completely automated analysis of corneal inflammatory cellular components with high accuracy. The implementation of such models would greatly benefit the management of corneal diseases and reduce workloads for ophthalmologists.

scholarly journals Evaluation of Corneal Nerves and Dendritic Cells By in Vivo Confocal Microscopy After Descemet’s Membrane Keratoplasty For Bullous Keratopathy

2022 ◽  
Author(s):  
Takahiko Hayashi ◽  
Atsuyuki Ishida ◽  
Akira Kobayashi ◽  
Takefumi Yamaguchi ◽  
Nobuhisa Mizuki ◽  
...  
Keyword(s):  
Dendritic Cells ◽  
Confocal Microscopy ◽  
Bullous Keratopathy ◽  
Dependent Manner ◽  
In Vivo Confocal Microscopy ◽  
Descemet Membrane Endothelial Keratoplasty ◽  
Corneal Nerves ◽  
Corneal Nerve ◽  
Number Of Branches

Abstract This study evaluated changes in corneal nerves and the number of dendritic cells (DCs) in corneal basal epithelium following Descemet membrane endothelial keratoplasty (DMEK) surgery for bullous keratopathy (BK). Twenty-three eyes from 16 consecutive patients that underwent DMEK for BK were included. Eyes of age-matched patients that underwent pre-cataract surgery (12 eyes) were used as controls. In vivo confocal microscopy was performed pre- and postoperatively at 6, 12, and 24 months. Corneal nerve length, corneal nerve trunks, number of branches, and the number of DCs were determined. The total corneal nerve length of 1634.7 ± 1389.1 μm /mm2 before surgery was significantly increased in a time-dependent manner to 4485.8 ± 1403.7 μm /mm2, 6949.5 ± 1477.1 μm /mm2, and 9389.2 ± 2302.2 μm /mm2 at 6, 12, and 24 months after DMEK surgery, respectively. The DC density in BK cornea pre- and postoperatively at 6 months was significantly higher than in the controls, and decreased postoperatively at 12 and 24 months and was significantly lower than that at 6 months postoperatively. Thus, our results suggest that DMEK can repair and normalize the corneal environment.

scholarly journals In vivo Confocal Microscopy in Differentiating Ipilimumab-Induced Anterior Uveitis from Metastatic Uveal Melanoma

2016 ◽  
Vol 7 (3) ◽  
pp. 404-409 ◽  
Author(s):  
Hayyam Kiratli ◽  
Mehmet C. Mocan ◽  
Murat İrkeç
Keyword(s):  
Visual Acuity ◽  
Confocal Microscopy ◽  
Uveal Melanoma ◽  
Anterior Uveitis ◽  
Choroidal Melanoma ◽  
Inflammatory Cells ◽  
In Vivo Confocal Microscopy ◽  
Keratic Precipitates ◽  
Metastatic Process

This report aims to describe the facilitating role of in vivo confocal microscopy in differentiating inflammatory cells from a metastatic process in a patient with uveal melanoma and multiple systemic metastases who developed anterior uveitis while under ipilimumab treatment. A 43-year-old woman developed systemic metastases 11 months after treatment of amelanotic choroidal melanoma in her right eye with 30 Gy fractionated stereotactic radiotherapy. She first received temozolomide and then 4 cycles of ipilimumab 3 mg/kg/day. After the third cycle, severe anterior uveitis with coarse pigment clumps on the lens was seen in the left eye. Her left visual acuity declined from 20/20 to 20/80. Confocal microscopy revealed globular keratic precipitates with hyperreflective inclusions and endothelial blebs all suggestive of granulomatous uveitis. The uveitic reaction subsided after a 3-week course of topical corticosteroids, and her visual acuity was 20/20 again. Although uveal melanoma metastatic to the intraocular structures of the fellow eye is exceedingly rare and metastasis masquerading uveitis without any identifiable uveal lesion is even more unusual, it was still mandatory to rule out this distant possibility in our particular patient who already had widespread systemic metastases. Confocal microscopy was a useful complementary tool by identifying the inflammatory features of the keratic precipitates.

Corneal epithelial dendritic cells in patients with multiple sclerosis: An in vivo confocal microscopy study

2020 ◽  
Vol 81 ◽  
pp. 139-143
Author(s):  
Valeria Testa ◽  
Nicole De Santis ◽  
Riccardo Scotto ◽  
Piero Della Giustina ◽  
Lorenzo Ferro Desideri ◽  
...  
Keyword(s):  
Multiple Sclerosis ◽  
Dendritic Cells ◽  
Confocal Microscopy ◽  
Microscopy Study ◽  
In Vivo Confocal Microscopy ◽  
Corneal Epithelial

scholarly journals Laser Scanning In Vivo Confocal Microscopy of Clear Grafts after Penetrating Keratoplasty

2016 ◽  
Vol 2016 ◽  
pp. 1-6 ◽  
Author(s):  
Dai Wang ◽  
Peng Song ◽  
Shuting Wang ◽  
Dapeng Sun ◽  
Yuexin Wang ◽  
...  
Keyword(s):  
Dendritic Cells ◽  
Confocal Microscopy ◽  
Corneal Endothelium ◽  
Laser Scanning ◽  
Penetrating Keratoplasty ◽  
In Vivo Confocal Microscopy ◽  
Chronic Injury ◽  
Corneal Nerves ◽  
Endothelium Cells

Purpose.To evaluate the changes of keratocytes and dendritic cells in the central clear graft by laser scanning in vivo confocal microscopy after penetrating keratoplasty (PK).Methods.Thirty adult subjects receiving PK at Shandong Eye Institute and with clear grafts and no sign of immune rejection after surgery were recruited into this study, and 10 healthy adults were controls. The keratocytes and dendritic cells in the central graft were evaluated by laser scanning confocal microscopy, as well as epithelium cells, keratocytes, corneal endothelium cells, and corneal nerves (especially subepithelial plexus nerves).Results.Median density of subepithelial plexus nerves, keratocyte density in each layer of the stroma, and density of corneal endothelium cells were all lower in clear grafts than in controls. The dendritic cells of five (16.7%) patients were active in Bowman’s membrane and stromal membrane of the graft after PK.Conclusions.Activated dendritic cells and Langerhans cells could be detected in some of the clear grafts, which indicated that the subclinical stress of immune reaction took part in the chronic injury of the clear graft after PK, even when there was no clinical rejection episode.

scholarly journals Observation of Chronic Graft-Versus-Host Disease Mouse Model Cornea with In Vivo Confocal Microscopy

Diagnostics ◽  
2021 ◽  
Vol 11 (8) ◽  
pp. 1515
Author(s):  
Shota Shimizu ◽  
Shinri Sato ◽  
Hiroko Taniguchi ◽  
Eisuke Shimizu ◽  
Jingliang He ◽  
...  
Keyword(s):  
Confocal Microscopy ◽  
Mouse Model ◽  
Graft Versus Host Disease ◽  
Pathological Condition ◽  
Inflammatory Cells ◽  
In Vivo Confocal Microscopy ◽  
Host Disease ◽  
Epithelial Damage ◽  
Graft Versus Host

Graft-versus-host disease (GVHD) is a major complication after hematopoietic stem cell transplantation (HSCT), and ocular GVHD can cause severe dry eye disease that can lead to visual impairment. Epithelial damage, vascular invasion, corneal fibrosis, and corneal perforation may occur in severe cases. It is generally accepted that inflammatory cells such as dendritic cells and T cells contribute to this pathological condition. However, it is still unknown what pathological condition occurs on the ocular surface after HSCT, and when. We therefore observed the dynamics of inflammatory cells in the cornea of chronic GVHD (cGVHD) model mice from 1 to 4 weeks after bone marrow transplantation (BMT) by in vivo confocal microscopy (IVCM) and considered the relationship with the pathophysiology of ocular GVHD (tear volume, corneal epithelial damage). In the allogeneic group, neovascularization occurred in all eyes at 1 week after BMT, although almost all vessels disappeared at 2 weeks after BMT. In addition, we revealed that infiltration of globular cells, and tortuosity and branching of nerves in the cornea occurred in both cGVHD mice and human cGVHD patients. Thus, we consider that cGVHD mouse model study by IVCM reproduces the state of ocular GVHD and may contribute to elucidating the pathological mechanism for ocular GVHD.

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