Abstract
The morphometric assessment of the corneal subbasal nerve plexus (SNP) by confocal microscopy holds great potential as a sensitive biomarker for various ocular and systemic conditions and diseases. Automated wide-field montages (or large-area mosaic images) of the SNP provide an opportunity to overcome the limited field of view of the available imaging systems without the need for manual, subjective image selection for morphometric characterization. However, current wide-field montaging solutions usually calculate the mosaic image after the examination session, without a reliable means for the clinician to predict or estimate the resulting mosaic image quality during the examination. This contribution describes a novel approach for a real-time creation and visualization of a mosaic image of the SNP that facilitates an informed evaluation of the quality of the acquired image data immediately at the time of recording. In cases of insufficient data quality, the examination can be aborted and repeated immediately, while the patient is still at the microscope. Online mosaicking also offers the chance to identify an overlap of the imaged tissue region with previous SNP mosaic images, which can be particularly advantageous for follow-up examinations.
Highlights
The morphometric assessment of the corneal subbasal nerve plexus (SNP) by confocal microscopy holds great potential as a sensitive biomarker for various ocular and systemic conditions and diseases
It is commonly accepted that reliable quantitative characterization of the SNP morphology needs to be based on a significantly larger area of the SNP9–12
The live presentation of the fast-changing sequence of acquired image frames is the only source of information available during the recording process, which is insufficient in practice to reliably predict the size or quality of the SNP mosaic image that is calculated from the dataset subsequently
Summary
The morphometric assessment of the corneal subbasal nerve plexus (SNP) by confocal microscopy holds great potential as a sensitive biomarker for various ocular and systemic conditions and diseases. In vivo corneal confocal microscopy (CCM) is the current state of the art technique for obtaining high-quality images of the subbasal nerve plexus (SNP) at the epithelial basement membrane[1,2] Using this technology, the morphology of the SNP has been studied as a conveniently accessible biomarker in various conditions such as dry eye d isease[3], diabetic neuropathy4,5, chemotherapy[6], HIV infection[7], and Parkinson’s d isease[8]. Typical dataset sizes for wide-field montages are in the order of several hundred images[16–18,22], so manually controlled data collection methods are not feasible as a routine task This has been solved by different approaches to guide the patients’ view direction, and their eye movements, while image sequences are being recorded[16,17,19]. It suffers from the same issues as other 2D-only imaging approaches as described above
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