Morphological and topological image analysis for clinical diagnostics and monitoring of cornea damage

The cornea is the transparent front part of the eye that covers the iris, pupil, and anterior chamber. A clear cornea is essential for good vision. Chemical and thermal burns to the eye constitute a serious form of injury with potentially catastrophic long-term consequences to patients including chronic eye pain, poor vision and frequently blindness. These injuries affect the quality of life of the patients and their families and have a strong negative impact on society. The reported incidence of ocular chemical injuries in the UK ranges from 7% to 10% among all ocular traumas. The annual incidence of chemical injuries in the north-eastern UK is 5.6 cases per 100,000 population, higher than the overall UK rate of 0.02 per 100,000 population per annum. The frequency of thermal cornea burns in the UK peaks during and after the fireworks seasons (Bonfire Night, New Year Eve, etc.). Chemical burns of the cornea have doubled in numbers over the last two years due to "acid attacks" as has been recently reported by the Home Office.

Assessment and diagnosis of cornea damage involves inspection of microscopic photographs of the cornea at various depths and relies on the identification of the shapes and arrangements of the cornea cells, especially in its epithelial layer. Distinctions between healthy and strongly damaged cornea are often easily discernible, but monitoring of the post-operative recovery involves more subtle, gradual changes that are difficult to identify without dedicated quantitative analysis. Meanwhile, such changes are critical to discover and characterise in order to assess the success of the medical treatments and to inform their strategy.

In this project, a practising ophthalmologist and cell biologist will combine their effort with astrophysicists and applied mathematicians to develop quantitative, computer-aided methods of analysis of microscopic cornea photographs in order to facilitate diagnostics and monitoring of the cornea damage.

Image analysis is at the heart of astronomy and, fundamentally, analyses of telescopic and microscopic images have much in common. Building upon advanced morphological and topological methods of statistical image analysis developed in the current STFC grant in application to to astronomical images, we propose to develop tools for quantitative clinical diagnostics of cornea cell damage based on approximately 100,000 in vivo confocal microscopic cornea images of healthy and damaged eyes obtained from patients of the Royal Victoria Infirmary (NHS, Newcastle upon Tyne). The aim of this project is to explore and apply novel, advanced mathematical methods of image analysis to identify and quantify the nature and degree of cornea damage and monitor its post-operative recovery, both general and patient-specific. Our ambition is to develop, eventually, a software package that could be used by ophthalmologists in their day-to-day clinical work in order to facilitate a speedy, objective and reliable diagnostics, damage assessment, monitoring progression of disease and response to surgical intervention, and to provide a suitably accurate and reproducible diagnostic and monitoring methods to assist in the day-to-day medical decision making.

This project will provide practising ophthalmologists with pioneering computer-based diagnostic tools for assessing and pre- and post-operative monitoring of chemical and thermal cornea damage. The economy of the medical practitioners' time and effort resulting from computerised analysis of hundreds and thousands of individual micro-photographs of the cornea will be very substantial with enormous benefit for patients. Moreover, the use of quantitative methods will improve the reliability of diagnosis and particularly post-operative monitoring consequently improving patient care.

Researchers and practitioners in clinical ophthalmology, image analysis, computer science, astrophysics, and above all patients, will benefit from results obtained in this project.

One of the outcomes of this project will be the development of a user-friendly and easy to use diagnostic and monitoring software to be used in hospital ophthalmology clinics. The patients, their families and society in general will be direct beneficiaries of our work. Cornea damage is a major cause of blindness around the world with a significant negative impact at both personal and societal levels as it profoundly affects the patients' quality of life. This project will produce direct and immediate positive impact for the patients, their families and society in general, locally, nationally and internationally.