Devices and methods for assessing changes in corneal health

1. A computer-implemented method for use in assessing a cornea, which comprises:

automatically selecting a principal image of the cornea for quantitative analysis from among a series of layered two-dimensional images of the cornea based on selection criteria met by at least one corneal structure in the principle image, wherein selecting a principal image comprises selecting an image with the most prominent nerves from among the series of layered two-dimensional images;

detecting a plurality of corneal structures in the selected principal image based on attributes of the principle image that represent the plurality of corneal structures; and

quantitatively analyzing the principle image by automatically computing quantitative attributes of at least one corneal structure of the detected plurality of corneal structures.

2. The computer-implemented method of claim 1 wherein the series of layered two-dimensional images comprises a series of layered confocal microscopy images of the cornea.

3. The computer-implemented method of claim 1 wherein the plurality of corneal structures comprises a plurality of nerves.

4. The computer-implemented method of claim 1 wherein the plurality of corneal structures comprises a plurality of immune cells.

5. The computer-implemented method of claim 1 which further comprises selecting a secondary image from among the series of layered two-dimensional images of the cornea and detecting a plurality of wing cells in the secondary image.

6. The computer-implemented method of claim 1 which further comprises displaying a graphical representation of the plurality of corneal structures.

7. The computer-implemented method of claim 6 which further comprises receiving user input and modifying the graphical representation of the plurality of the corneal structures in response to the user input.

8. The computer-implemented method of claim 1 which further comprises generating a three-dimensional view of at least one of the plurality of corneal structures.

9. The computer-implemented method of claim 1 which further comprises selecting an anterior image and a posterior image to the principal image from among the series of layered two-dimensional images of the cornea, and registering a common reference point in each of the principal, anterior, and posterior images.

10. The computer-implemented method of claim 1 wherein the at least one corneal structure comprises at least one nerve and wherein the selection criteria comprises at least one of a size and a quantity of the at least one corneal structure.

11. A non-transitory computer readable medium with computer executable instructions stored thereon adapted to analyze corneal structures depicted in a series of layered two-dimensional images of a cornea, the computer executable instructions which comprise:

selecting a principal image from among the series of layered two-dimensional images of the cornea for quantitative analysis based on selection criteria met by at least one corneal structure in the principle image, wherein selecting a principal image comprises selecting an image with the most prominent nerves from among the series of layered two-dimensional images;

detecting a first type of corneal structure in the principal image based on attributes of the principal image that represent the first type of corneal structure; and

quantitatively analyzing the first type of corneal structure in the principal image by automatically computing quantitative attributes of the first type of corneal structure.

12. The computer readable medium of claim 11 wherein the first type of corneal structure comprises nerves.

13. The computer readable medium of claim 11 wherein the first type of corneal structure comprises immune cells.

14. The computer readable medium of claim 11 wherein the computer executable instructions further comprise selecting a secondary image from among the series of layered two-dimensional images and detecting a plurality of wing cells in the secondary image.

15. The computer readable medium of claim 14 wherein selecting a secondary image includes selecting an image approximately 20 μm anterior to the principal image from among the series of layered two-dimensional images.

16. The computer readable medium of claim 11 wherein the computer executable instructions further comprise displaying a graphical representation of the first type of corneal structure.

17. The computer readable medium of claim 11 wherein the computer executable instructions further comprise generating a three-dimensional image including at least the principal image.

18. The computer readable medium of claim 17 wherein the three-dimensional image further comprises an anterior image and a posterior image to the principal image selected from among the series of layered two-dimensional images of the cornea.

19. The computer readable medium of claim 18 wherein generating the three-dimensional image comprises registering a common reference point in each of the principal, anterior, and posterior images.

20. A method for generating a three-dimensional image of a portion of a cornea, which comprises:

selecting a principal image from among a series of layered two-dimensional images of the portion of the cornea based on selection criteria met by at least one corneal structure in the principal image, wherein selecting a principal image comprises selecting an image with the most prominent nerves from among the series of layered two-dimensional images;

identifying an anterior image to the principal image from among the series of layered images of the portion of the cornea;

identifying a posterior image to the principal image from among the series of layered images of the portion of the cornea;

identifying a feature of the cornea visible in each of the principal, anterior, and posterior images;

registering the feature of the cornea in each of principal, anterior, and posterior images; and

rendering the three-dimensional image of the portion of the cornea using at least the principal, anterior, and posterior images from among the series of layered images of the cornea.

21. The method of claim 20 wherein rendering the three-dimensional image comprises rendering the three-dimensional image in a composite/volume mode.

22. The method of claim 20 wherein rendering the three-dimensional image comprises rendering the three-dimensional image in an isosurface mode.

23. The method of claim 20 wherein rendering the three-dimensional image comprises rendering the three-dimensional image in a slice mode.

24. The method of claim 20 which further comprises providing a quantitative analysis of the portion of the cornea.

25. The method of claim 20 wherein the portion of the cornea comprises a nerve plexus.

26. The method of claim 25 which further comprises graphically segmenting nerves in the nerve plexus.

27. The method of claim 25 which further comprises graphically segmenting immune cells proximate to the nerve plexus.