Automated qualitative and quantitative assessment of posterior capsule opacification by Automated Quantification of After-Cataract II (AQUA II) system

Martin Kronschläger, Hannes Siegl, Axel Pinz, Christoph Feichtenhofer, Wolf Buehl, Nino Hirnschall, Oliver Findl

Research output: Contribution to journalArticleResearchpeer-review

Abstract

Background: The present study aims to investigate an automated qualitative and quantitative assessment system (Automated Quantification of After-Cataract [AQUA II]) of posterior capsule opacification (PCO) in high-resolution digital retroillumination images and consequently reduce observer bias and increase accuracy of PCO grading. Methods: A data set of 100 eyes with no to severe PCO was analysed. Ten eyes were consecutively photographed twice and ten images were rotated to give a total of 120 images for PCO assessment. Validity was determined by including subjective grading and repeatability was determined by evaluating the 20 additional images. Evaluation of posterior capsular opacification (EPCO), posterior capsule opacity (POCO) and AQUA I methods were included for comparative analysis of the data. Results: The system developed proved to classify six types of PCO. Validity was confirmed by a Pearson correlation coefficient of r = 0.95 (EPCO r = 0.93; POCO r = 0.72 and AQUA I r = 0.94). Repeatability was better in AQUA II (95% confidence interval [CI] for mean difference: 0.5 ± 1.2) than in subjective grading (95% CI for mean difference: 0.6 ± 1.7), in EPCO grading (95% CI for mean difference:-0.2 ± 1.5), in POCO grading (95% CI for mean difference: 1.6 ± 2.7) and in AQUA I (95% CI for mean difference:-1.1 ± 1.9). Conclusions: AQUA II is a system that for the first time not only objectively quantifies PCO, but also qualitatively assesses PCO in an automated manner with texture classification. AQUA II showed an excellent validity and repeatability.

Original languageEnglish
Article number114
Pages (from-to)114
Number of pages8
JournalBMC Ophthalmology
Volume19
Issue number1
DOIs
Publication statusPublished - 2019

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Capsule Opacification
Cataract
Confidence Intervals
Capsules
Observer Variation

Keywords

  • AQUA
  • Automated quantification of after-cataract
  • Posterior capsule opacification
  • Retroillumination image

ASJC Scopus subject areas

  • Ophthalmology

Cite this

Automated qualitative and quantitative assessment of posterior capsule opacification by Automated Quantification of After-Cataract II (AQUA II) system. / Kronschläger, Martin ; Siegl, Hannes; Pinz, Axel; Feichtenhofer, Christoph; Buehl, Wolf ; Hirnschall, Nino; Findl, Oliver.

In: BMC Ophthalmology, Vol. 19, No. 1, 114, 2019, p. 114.

Research output: Contribution to journalArticleResearchpeer-review

Kronschläger, Martin ; Siegl, Hannes ; Pinz, Axel ; Feichtenhofer, Christoph ; Buehl, Wolf ; Hirnschall, Nino ; Findl, Oliver. / Automated qualitative and quantitative assessment of posterior capsule opacification by Automated Quantification of After-Cataract II (AQUA II) system. In: BMC Ophthalmology. 2019 ; Vol. 19, No. 1. pp. 114.
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abstract = "Background: The present study aims to investigate an automated qualitative and quantitative assessment system (Automated Quantification of After-Cataract [AQUA II]) of posterior capsule opacification (PCO) in high-resolution digital retroillumination images and consequently reduce observer bias and increase accuracy of PCO grading. Methods: A data set of 100 eyes with no to severe PCO was analysed. Ten eyes were consecutively photographed twice and ten images were rotated to give a total of 120 images for PCO assessment. Validity was determined by including subjective grading and repeatability was determined by evaluating the 20 additional images. Evaluation of posterior capsular opacification (EPCO), posterior capsule opacity (POCO) and AQUA I methods were included for comparative analysis of the data. Results: The system developed proved to classify six types of PCO. Validity was confirmed by a Pearson correlation coefficient of r = 0.95 (EPCO r = 0.93; POCO r = 0.72 and AQUA I r = 0.94). Repeatability was better in AQUA II (95{\%} confidence interval [CI] for mean difference: 0.5 ± 1.2) than in subjective grading (95{\%} CI for mean difference: 0.6 ± 1.7), in EPCO grading (95{\%} CI for mean difference:-0.2 ± 1.5), in POCO grading (95{\%} CI for mean difference: 1.6 ± 2.7) and in AQUA I (95{\%} CI for mean difference:-1.1 ± 1.9). Conclusions: AQUA II is a system that for the first time not only objectively quantifies PCO, but also qualitatively assesses PCO in an automated manner with texture classification. AQUA II showed an excellent validity and repeatability.",
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