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Automated Tissue Segmentation Software for Assessing Global Area of Cell Damage After Descemet Membrane Endothelial
Hannah J Hwang1, Peter Bedard1, Mark Cavaleri2
1Lions Gift of Sight Eye Bank, St. Paul, MN.
Purpose:
The purpose of this study was to 1) determine the feasibility of imaging donor corneas during sterile tissue processing for computer vision endothelial cell viability analysis and to 2) compare the accuracy of automated software versus manual segmentation versus operator estimates in measuring percent area of cell damage (%ACD) on trypan-stained, postprocessed Descemet membrane endothelial keratoplasty (DMEK) corneas.
Methods:
Donor corneas were peeled for DMEK and stained with 0.06% trypan blue for 90 seconds and then photographed with a high-resolution microscope camera under sterile conditions in a biosafety cabinet before preloading into an injector or placing in a cornea viewing chamber. The corneas were evaluated for global cell viability based on %ACD using 3 methods: 1) manual Weka segmentation software (ImageJ, National Institute of Health, Bethesda, MD), 2) Kerify (custom-built Aphelion application, ADCIS, S.A., Saint-Contest, France), and 3) technician estimates. The %ACD measured was compared across all 3 modalities using 1-way ANOVA and regression analysis.
Results:
Standardized whole graft viability imaging was performed for 50 consecutive transplant DMEK grafts. There was no significant difference in group means between Kerify, manual software, and technician estimates in measuring cell damage (5.8% vs. 5.4% vs. 6.1%, P = 0.24). However, at higher ACD levels, Kerify-using manual Weka segmentation software as the reference standard-was more precise than technician estimates at predicting ACD.
Conclusions:
Our automated ACD computer vision software Kerify saves time, removes bias, and demonstrates good accuracy compared with manual computer segmentation. Kerify may be a powerful new tool for postprocessing tissue evaluation.
