Characterising corneal changes in aniridia-related keratopathy using in vivo confocal microscopy and a self-supervised AI model.

IF 2 Q2 OPHTHALMOLOGY
Abigail Eve Kaye, Yalin Zheng, Sajjad Ahmad
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引用次数: 0

Abstract

Purpose: To investigate whether corneal changes observed via in vivo confocal microscopy (IVCM) in patients with aniridia-related keratopathy (ARK) reflect clinical severity.

Methods: A cross-sectional, observational study. Patients with congenital aniridia and healthy controls were included. IVCM of the epithelium, anterior stroma and posterior stroma were collected, manually annotated and analysed using the pretrained DINOv2 model as a feature extractor. High-dimensional embeddings were visualised using t-distributed stochastic neighbour embedding (t-SNE) to assess layer-specific clustering. Structural deviations from normal controls were quantified using centroid and Euclidean distance metrics. The cumulative structural changes across corneal layers were then correlated with Ocular Surface Score (OSS), a clinical grading scale for ARK severity.

Results: 20 patients with congenital aniridia and six healthy controls were included. t-SNE analysis revealed distinct clusters for normal corneal layers; whereas, ARK samples displayed overlapping clusters, suggestive of blurred structural boundaries. Notably, significant clustering patterns were observed in the anterior stroma, even in cases with mild ARK, underscoring its potential as an early disease marker. Anterior stromal changes were significantly associated with OSS scores (p<0.05), while cumulative structural deviations across all layers demonstrated a stronger correlation with disease severity (p<0.01). The posterior stroma showed relative structural preservation, aligning closely with healthy controls.

Conclusion: DINOv2 is a useful tool for identifying subtle structural changes in corneal layers affected by ARK. The corneal stromal features characterised using IVCM showed strong associations with clinical disease and may serve as structural biomarkers of clinical disease.

利用体内共聚焦显微镜和自监督人工智能模型表征无虹膜相关性角膜病变的角膜变化。
目的:探讨无虹膜相关性角膜病变(ARK)患者体内共聚焦显微镜(IVCM)观察到的角膜变化是否能反映其临床严重程度。方法:横断面观察性研究。包括先天性无虹膜患者和健康对照者。收集上皮、前基质和后基质的IVCM,使用预训练的DINOv2模型作为特征提取器进行人工注释和分析。高维嵌入使用t分布随机邻居嵌入(t-SNE)可视化,以评估层特异性聚类。使用质心和欧氏距离度量来量化与正常对照的结构偏差。然后将角膜各层的累积结构变化与眼表评分(OSS)相关联,OSS是ARK严重程度的临床分级量表。结果:20例先天性无虹膜患者和6例健康对照。t-SNE分析显示正常角膜层明显聚集;而ARK样品显示重叠簇,暗示结构边界模糊。值得注意的是,即使在轻度ARK病例中,在前间质中也观察到显著的聚类模式,强调了其作为早期疾病标志物的潜力。前间质改变与OSS评分显著相关(p)结论:DINOv2是识别ARK影响的角膜层细微结构变化的有用工具。使用IVCM表征的角膜基质特征与临床疾病有很强的相关性,可以作为临床疾病的结构性生物标志物。
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来源期刊
BMJ Open Ophthalmology
BMJ Open Ophthalmology OPHTHALMOLOGY-
CiteScore
3.40
自引率
4.20%
发文量
104
审稿时长
20 weeks
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