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Article

Validation of the Use of Automated and Manual Quantitative Analysis of Corneal Nerve Plexus Following Refractive Surgery

1
Singapore Eye Research Institute, Singapore 168751, Singapore
2
School of Medicine, Trinity College Dublin, D02 PN40 Dublin, Ireland
3
Ophthalmic Clinic, University “G d’Annunzio” of Chieti-Pescara, Via dei Vestini, 66100 Chieti, Italy
4
Department of Biostatistics, Duke-NUS Medical School, Singapore 169857, Singapore
5
Department of Cornea and External Eye Disease, Singapore National Eye Centre, Singapore 168751, Singapore
6
Ophthalmology and Visual Sciences Academic Clinical Program, Duke-NUS Medical School, Singapore 169857, Singapore
*
Author to whom correspondence should be addressed.
Diagnostics 2020, 10(7), 493; https://doi.org/10.3390/diagnostics10070493
Received: 12 June 2020 / Revised: 14 July 2020 / Accepted: 15 July 2020 / Published: 18 July 2020
(This article belongs to the Special Issue Dry Eye and Ocular Surface Disorders)
Following refractive surgery, the cornea is denervated and re-innervated, hence a reproducible tool to objectively quantify this change is warranted. This study aimed to determine the repeatability and reproducibility of corneal nerve quantification between automated (ACCMetrics) and manual software (CCMetrics) following refractive surgery. A total of 1007 in vivo confocal microscopy images from 20 post-small incision lenticule extraction (SMILE) or post-laser-assisted in situ keratomileusis (LASIK) patients were evaluated by two independent observers using CCMetrics for corneal nerve fibre density (CNFD), corneal nerve branch density (CNBD), and corneal nerve fibre length (CNFL). Intra-observer and inter-observer reproducibility and repeatability, as well as agreement and correlation between the measurements obtained by ACCMetrics and CCMetrics, were assessed. We found that CNFL demonstrated the best intra- and inter-observer agreement followed by CNFD (intra-class correlation coefficient (ICC) = 0.799 and 0.740, respectively for CNFL; 0.757 and 0.728 for CNFD). CNBD demonstrated poorest intra- and inter-observer ICC. There was an underestimation in ACCMetrics measurements compared to CCMetrics measurements, although the differences were not significant. Our data suggested that both automated and manual methods can be used as reliable tools for the evaluation of corneal nerve status following refractive surgery. However, the measurements obtained with different methods are not interchangeable. View Full-Text
Keywords: corneal nerves; refractive surgery; automated quantification; manual quantification corneal nerves; refractive surgery; automated quantification; manual quantification
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MDPI and ACS Style

Chin, J.Y.; Yang, L.W.Y.; Ji, A.J.S.; Nubile, M.; Mastropasqua, L.; Allen, J.C.; Mehta, J.S.; Liu, Y.-C. Validation of the Use of Automated and Manual Quantitative Analysis of Corneal Nerve Plexus Following Refractive Surgery. Diagnostics 2020, 10, 493. https://doi.org/10.3390/diagnostics10070493

AMA Style

Chin JY, Yang LWY, Ji AJS, Nubile M, Mastropasqua L, Allen JC, Mehta JS, Liu Y-C. Validation of the Use of Automated and Manual Quantitative Analysis of Corneal Nerve Plexus Following Refractive Surgery. Diagnostics. 2020; 10(7):493. https://doi.org/10.3390/diagnostics10070493

Chicago/Turabian Style

Chin, Jia Ying, Lily Wei Yun Yang, Angel Jung Se Ji, Mario Nubile, Leonardo Mastropasqua, John Carson Allen, Jodhbir S. Mehta, and Yu-Chi Liu. 2020. "Validation of the Use of Automated and Manual Quantitative Analysis of Corneal Nerve Plexus Following Refractive Surgery" Diagnostics 10, no. 7: 493. https://doi.org/10.3390/diagnostics10070493

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