Title Page
Contents
Abstract 10
Chapter Ⅰ. Development of Central Corneal Fluorescein Staining Grading; a New Approach to Qualitative Dry eye Diagnosis Using Digital Image Analysis in Rabbits 13
1.1. Introduction 13
1.2. Materials and Methods 15
1.2.1. Experimental animals 15
1.2.2. Experimental procedure 16
1.2.3. Non-invasive tear break up time 17
1.2.4. Corneal fluorescein staining 18
1.2.5. Grading of corneal fluorescein staining the national eye institute 19
1.2.6. Image standardization 20
1.2.7. Extracting corneal fluorescein staining area 22
1.2.8. Image superimposition process 24
1.2.9. Find central corneal area 26
1.2.10. Statistical analysis 29
1.3. Results 30
1.3.1. Inter-observer reliability of the national eye institute 30
1.3.2. Correlation between the national eye institute and central cornea fluorescein density 30
1.3.3. The central cornea fluorescein grading system 31
1.3.4. Comparison between the national eye institute and central cornea fluorescein grading 31
1.4. Discussion 37
Chapter Ⅱ. Central Corneal Fluorescein Staining Grading for Qualitative Dry Eye Diagnosis using Digital Image Analysis : Application in Dogs 43
2.1. Introduction 43
2.2. Materials and Methods 45
2.2.1. Experimental animals 45
2.2.2. Dry eye questionnaire 46
2.2.3. Schirmer tear test 1 47
2.2.4. Non-invasive tear break up time 48
2.2.5. Meibography 49
2.2.6. Corneal fluorescein staining 50
2.2.7. Grading of corneal fluorescein staining by the national eye institute 51
2.2.8. Image standardization 52
2.2.9. Extracting corneal fluorescein staining area 54
2.2.10. Finding the central cornea fluorescein grading 56
2.2.11. Score of dry eye examination 57
2.2.12. Statistical analysis 59
2.3. Results 60
2.3.1. Result of dry eye examination 60
2.3.2. Inter-observer reliability of the National Eye Institute 60
2.3.3. Compare the mean values of various dry eye examinations between non-dry eyes and dry eyes 62
2.3.4. Concurrent validity between central cornea fluorescein grading and various variables 64
2.3.5. Comparison of dry eye discrimination between the national eye institute scale and new central cornea fluorescein grading 66
2.4. Discussion 69
Conclusion 72
References 73
Abstract (in Korean) 78
Table 1-1. Central cornea fluorescein density according to the national eye institute 32
Table 1-2. Optimal cut-off point of central cornea fluorescein density for the higher grade of NEI 35
Table 1-3. The central cornea fluorescein grading[내용없음] 8
Table 2-1. The Central Cornea Fluorescein Grading 56
Table 2-2. Score of dry eye examination 58
Table 2-3. Result of dry eye examination 61
Table 2-4. Compare the mean values of various dry eye examinations between non-dry eyes and dry eyes 63
Table 2-5. Concurrent validity between central cornea fluorescein grading and various variables 65
Table 2-6. The area under the curve determined by receiver operating characteristic curves to classifying dry eye disease 68
Figure 1-1. Horizontalization images and finding the center of the eye. 21
Figure 1-2. Extracting corneal fluorescein staining area. 23
Figure 1-3. Image superimposition based on each grade. 25
Figure 1-4. Find central corneal area. 27
Figure 1-5. Determine central corneal size. 28
Figure 1-6. Box plot of the national eye institute and central corneal fluorescein density. 33
Figure 1-7. Receiver operating characteristic curves of adjacent grades. 34
Figure 1-8. Receiver operating characteristic curve by classifying dry eye based on non-invasive tear break up time. 36
Figure 2-1. Horizontalization images and finding the center of the eye. 53
Figure 2-2. Extracting corneal fluorescein staining area. 55
Figure 2-3. Receiver operating characteristic curve by classifying dry eye based on non-invasive tear break up time. 67