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Evaluation of repeatability for the automatic estimation of endothelial cell density in donor corneas
  1. Alfredo Ruggeri1,
  2. Enrico Grisan1,
  3. Jan Schroeter2
  1. 1
    Department of Information Engineering, University of Padova, Padova, Italy
  2. 2
    Cornea Bank Berlin, Clinic of Ophthalmology, Charité-Universitätsmedizin Berlin, Campus Virchow-Klinikum, Germany
  1. Professor A Ruggeri, Department of Information Engineering, University of Padova, Via Gradenigo 6/B, 35131 Padova, Italy; alfredo.ruggeri{at}


Background/Aims: The repeatability of an automatic system for estimation of endothelial cell density (ECD) from microscopy images in donor corneas was assessed.

Methods: A computer program for the automatic ECD estimation from frequency analysis was previously presented. An evaluation of its repeatability was performed on a data set containing 200 corneas by assessing the accuracy and precision of automatic versus manual values. For each cornea, 2–21 images (1536 total) at 100× for automatic ECD and one image at 200× for manual ECD were available.

Results: Accuracy of automatic ECDs was −45 (SD 99) cells/mm2 (−2% (4%)). Precision of repeated automatic ECDs on the same cornea was 62 (30) cells/mm2 (3% (1%)). The algorithm was also capable of identifying all non-processable images.

Conclusion: The proposed automatic technique proved to be reliable for its routine use in a typical eye bank setting like the one considered here.

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  • Competing interests: A Ruggeri is a paid consultant for Nidek Technologies, Italy.

  • Abbreviations:

    Discrete Fourier Transform


    endothelial cell density


    region of interest