Statistical analysis of corneal OCT speckle: a non-parametric approach

Ultrasound Characterization of Oral Soft Tissues in vivo Using the Burr Speckle Model

Periodontal (gum) diseases, reportedly affect 4 out of 10 adults 30 years of age or older in the USA. The standard of care for clinical assessments of these diseases is bleeding on probing, which is invasive, subjective and semi-qualitative. Thus, research on proposing alternative noninvasive modalities for clinical assessments of periodontal tissues is crucial. Quantitative Ultrasound (QUS) has shown promises in noninvasive assessments of various diseases in soft biological tissues; however, it has not been employed in periodontology. Here as the first step, we focused on QUS-based characterization of two very adjacent oral soft tissues of alveolar mucosa and attached gingiva in an in vivo animal study. We investigated first order ultrasonic speckle statistics using the two-parameter Burr model (power-law b and scale factor l). Our QUS analysis was compared with the Masson's Trichrome histology images of the two oral tissue types quantitatively using the RGB color thresholding. QUS study included 10 swine and US scanning was performed at the first and second molars of all four oral quadrants in each swine, resulting in 80 scans. US scan data was acquired at the transit/receive frequency of 24 MHz using a toothbrush-sized transducer. Parametric imaging of Burr parameters was created using a sliding kernel method with linear interpolations. The kernel size and overlap ratio was 10 wavelengths and 70%, respectively. No statistically significant difference was reported for estimated parameters when interpolation was performed (p-value>0.01). Results at both oral sites (molar 1 and molar 2) showed that the difference between the two tissue types using Burr parameters were statistically significant (p-value<0.0001). The average Burr b was reported to be higher in attached gingiva while the average Burr l was lower compared to mucosa. Visual comparison of Masson Trichrome histology images of these tissues showed denser color density in gingiva. The color thresholding of these images further confirmed that the percent of blue, which stains collagenous regions, was at least two times higher in gingiva than alveolar mucosa, based on threshold values. Comparing histology and QUS in characterizing the two tissue types, it was suggested that the elevated Burr b (related to potential scatterer densities) in gingiva could be aligned with findings from Masson's Trichrome histology. This study showed a promising potential of QUS for periodontal soft tissue characterization.

Measuring intraocular pressure with OCT: the first approach

The variability of corneal OCT speckle statistics is indirectly related to changes in corneal microstructure, which may be induced by intraocular pressure (IOP). A new approach is considered, which attempts to estimate IOP based on corneal speckle statistics in OCT images. An area (A) under trajectories of contrast ratio with respect to stromal depth was calculated. The proposed method was evaluated on OCT images from the ex-vivo study on porcine eyeballs and in-vivo study on human corneas. A statistically significant multivariate linear regression model was obtained from the ex-vivo study: IOP = 0.70 · A - 6.11, in which IOP was precisely controlled in the anterior chamber. The ex-vivo study showed good correlation between A and IOP (R = 0.628, at the least) whereas the in-vivo study showed poor correlation between A and clinical air-puff tonometry based estimates of IOP (R = 0.351, at the most), indicating substantial differences between the two studies. The results of the ex-vivo study show the potential for OCT speckle statistics to be utilized for measuring IOP using static corneal imaging that does not require corneal deformation. Nevertheless, further work is needed to validate this approach in living human corneas.

OCT based corneal densitometry: the confounding effect of epithelial speckle

Corneal densitometry is a clinically validated method for objectively assessing the transparency of stroma. The technique is currently dominated by Scheimpflug technology. Still, optical coherence tomography (OCT), in which examination of the statistical properties of corneal speckle is undertaken, has also been considered to assess corneal densitometry. In-vivo, the stroma is observed via the epithelium. However, the effect of this external layer on stromal densitometry has not been considered as yet. This study aims to quantify the influence of epithelium integrity on corneal OCT densitometry. OCT images from eleven freshly enucleated porcine eyes before and after epithelial debridement were used. OCT densitometry was investigated at different stromal depths using four metrics of speckle statistics. Results indicate that there exist statistically significant differences in speckle statistics for a given stromal depth depending on the presence or absence of the epithelium. The estimation error in speckle statistics can reach over 20% depending on the stromal depth. The anterior stroma densitometry values are the ones most affected by epithelial integrity. In conclusion, if OCT densitometry stromal parameters are to be considered in absolute terms, it is essential to consider the confounding effect of the epithelial layer in the analysis.

Assessing and compensating for the confounding factors in Scheimpflug-based corneal densitometry

Scheimpflug-based corneal densitometry is a clinically verified method for assessing corneal transparency. Nevertheless, the estimates of corneal densitometry appear to be correlated with age and eye biometry parameters, such as the anterior chamber depth or the pupil size, and that ensues a convoluted conditional estimation problem, where it is difficult to interpret the results. This study aims at devising a methodology for compensating for such confounding factors by using, as a research platform, a commercially available Scheimpflug camera that allows exporting images in a dynamic fashion, allowing averaging the results from multiple acquisitions. Two approaches are considered, one based on appropriately normalizing the line densitometry signal and one based on image histogram equalization. Then, three parameters for describing corneal densitometry are derived including the mean value of backscatter and the scale and shape parameters of the Weibull distribution estimated in regions of interest encompassing parts of corneal stroma. The results show that, unlike the non-normalized measures, the proposed approaches lead to parameters that are not correlated with age nor the eye biometry.

Speckle Contrast as Retinal Tissue Integrity Biomarker in Patients with Type 1 Diabetes Mellitus with No Retinopathy

PURPOSE

To study the retinal and choroidal layers in type 1 diabetes mellitus (DM1) without diabetic retinopathy (DR), using speckle contrast of optical coherence tomography (OCT) images as a tissue biomarker in comparison with healthy subjects.

METHODS

OCT Spectralis images of 148 eyes, 84 from DM1 patients without DR signs, and 64 belonging to the control group, were collected. The speckle contrast and thickness of the inner retinal layer (IRL), the outer retinal layer (ORL), and the choroidal layer in the nasal parafoveal area (N3), were prospectively analyzed.

RESULTS

A statistically significant difference (p = 0.001) in the IRL thickness between groups was observed, being thicker in the DM1 group. There were no differences in the ORL and choroidal thicknesses between groups. A statistically significant difference (p = 0.02) in the IRL speckle contrast was obtained, being lower in the DM1 group. The maximum speckle contrast was reached in the ORL for both groups, although in the DM1 group, it occurs closer to the choroid, at 64 ± 8 μm (p = 0.008).

CONCLUSIONS

Statistically significant differences were found in speckle contrast and thickness between the control and the DM1 group, suggesting an IRL alteration of DM1 patients, supporting the retinal neurodegeneration before DR signs are observed.

Age-related changes in dynamic corneal backscatter observed in Scheimpflug imaging

Corneal visualization Scheimpflug technology (Corvis ST) has the potential to indirectly provide information on corneal structure via the analysis of statistical properties of the backscatter. The aim of this work was to ascertain whether there are age-related changes in the dynamics of corneal backscatter during an air-puffed induced corneal deformation. Retrospective data from Corvis ST measurements of 151 young subjects (19-30 years) and 82 older subjects (50-87 years) were considered. Each measurement consisted of 140 frames (sampling frequency: 4330 fps). For every frame the cornea was first segmented, then regions of interest, encompassing temporal, central and nasal parts of cornea were selected, to which the parameters of Weibull distribution (scale and shape) were fitted, leading to time series of the estimated parameters. Apparent differences were found between the parameters of Weibull distribution between the two considered groups that manifest themselves mostly in the nasal region of the cornea. However, those differences cannot be attributed to the age alone. For this, a normalization method is proposed that leads to a much better separation between the groups in all considered regions. Clinical Relevance- The parameters of the corneal backscat-ter are widely used to asses corneal clarity (so-called corneal densitometry). Recently the parameters of Weibull distribution fitted to the corneal backscatter data have been used to support diagnosis of keratoconus. This work contributes to the assessment of corneal clarity by identifying the apparent age-related differences in those parameters when dynamic raw data is considered highlighting the need for such parameters to be appropriately normalized. Further it shown that the shape parameter of Weibull distribution unlike the scale parameter carries that information already for the raw non-normalized data.

Indirectly assessing changes in corneal properties with OCT speckle after crosslinking in porcine eyes

The aim of this study was to assess the effect of the standard crosslinking (CXL) procedure on corneal properties and subsequent changes in collagen bonds formation using optical coherence tomography (OCT) corneal speckle statistics and vibrational spectroscopy. Porcine eyes with intact corneal epithelium were randomly selected to one of the four study groups: (1) untreated eyes moistened with phosphate-buffered saline (PBS); (2) eyes after the epithelial debridement and riboflavin application; (3) eyes after CXL procedure according to the Dresden protocol; and (4) eyes after corneal epithelial debridement, regularly moistened with PBS. Before and after this selection, each eyeball was subjected to the constant intraocular pressure of 20 mmHg. Then, ocular biometry was performed and the central cornea was imaged using spectral-domain OCT. Following this, a nonparametric approach to speckle modeling (the Contrast Ratio (CR)) was utilized within the region of interest for each B-scan covering the central corneal stroma. To verify whether the CXL performed ex-vivo results in formation of new bonds in the cornea, Fourier Transform Infrared Attenuated Total Reflectance (ATR-FTIR) spectra of dried corneas, dissected from examined eyeballs, were collected and analyzed. Corneal epithelium removal alone or with the riboflavin application leads to a statistically significant decrease in the CR median value (the Wilcoxon signed-rank test, p < 0.05). However, the most pronounced change in CR median value, which decreases with the increased number of scatterers, was shown after the complete CXL procedure including riboflavin soaking and UVA irradiation (the Wilcoxon signed-rank test, p = 0.004). Analysis of ATR-FTIR spectra revealed influence of UVA irradiation on collagen matrix. The study has shown the increased dehydration accompanied by almost no alteration of collagen native triple-helical structure. Significant changes have been observed for bands related to collagen crosslinks. Specifically, the predominant changes occurred in the sugar region from 1150 to 975 cm^-1, as well as in the absorbance of carbonyl groups. Furthermore, the ratio of two Amide I components at approximately 1660 cm^-1 and 1675 cm^-1 decreased after UVA irradiation. Together, these results provided the evidence for the creation of new corneal crosslinks. In conclusion, this study clearly indicates that the UVA exposure causes the substantial difference in optical scattering occurring in corneal stroma as a result of the induced biochemical changes at the molecular level in this tissue assessed with ATR-FTIR. The proposed speckle-based methodology brings a new insight into the development of OCT technology useful in an indirect assessment of some collagen changes.

Local Burr distribution estimator for speckle statistics

Speckle statistics in ultrasound and optical coherence tomography have been studied using various distributions, including the Rayleigh, the K, and the more recently proposed Burr distribution. In this paper, we expand on the utility of the Burr distribution by first validating its theoretical framework with numerical simulations and then introducing a new local estimator to characterize sample tissues of liver, brain, and skin using optical coherence tomography. The spatially local estimates of the Burr distribution's power-law or exponent parameter enable a new type of parametric image. The simulation and experimental results confirm the potential for various applications of the Burr distribution in both basic science and clinical realms.

Signal-carrying speckle in optical coherence tomography: a methodological review on biomedical applications

SIGNIFICANCE

Speckle has historically been considered a source of noise in coherent light imaging. However, a number of works in optical coherence tomography (OCT) imaging have shown that speckle patterns may contain relevant information regarding subresolution and structural properties of the tissues from which it is originated.

AIM

The objective of this work is to provide a comprehensive overview of the methods developed for retrieving speckle information in biomedical OCT applications.

APPROACH

PubMed and Scopus databases were used to perform a systematic review on studies published until December 9, 2021. From 146 screened studies, 40 were eligible for this review.

RESULTS

The studies were clustered according to the nature of their analysis, namely static or dynamic, and all features were described and analyzed. The results show that features retrieved from speckle can be used successfully in different applications, such as classification and segmentation. However, the results also show that speckle analysis is highly application-dependant, and the best approach varies between applications.

CONCLUSIONS

Several of the reviewed analyses were only performed in a theoretical context or using phantoms, showing that signal-carrying speckle analysis in OCT imaging is still in its early stage, and further work is needed to validate its applicability and reproducibility in a clinical context.