In Vivo Confocal Microscopic Corneal Images in health and disease with an emphasis on extracting features and visual signatures for corneal diseases: A review study

There is an evolution in the demands of modern ophthalmology from descriptive findings to
assessment of cellular level changes by using in vivo confocal microscopy. Confocal microscopy,
by producing grey-scale images, enables a microstructural insight into the in vivo cornea in both
health and disease, including epithelial changes, stromal degenerative or dystrophic diseases,
endothelial pathologies, and corneal deposits and infections. Ophthalmologists use acquired
confocal corneal images to identify health and disease states and then to diagnose which type of
disease is affecting the cornea. This paper presents the main features of the healthy confocal corneal
layers, and reviews the most common corneal diseases. It identifies the visual signature of each
disease in the affected layer and extracts the main features of this disease in terms of intensity,
certain regular shapes with both their size and diffusion, and some specific region of interest. These
features will lead towards the development of a complete automatic corneal diagnostic system
which predicts abnormalities in the confocal corneal data sets.

The authors express their gratitude to the following publishers: Elsevier, BMJ, Springer, Wiley, Molecular Vision, Nature and the Korean Ophthalmological Society for giving permission to reproduce images published in their journals, which were used in this study.