Tomographic and Biomechanical Scheimpflug Imaging for Keratoconus Characterization: A Validation of Current Indices
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Tomographic and Biomechanical Scheimpflug Imaging for Keratoconus Characterization: A Validation of Current Indices. / Steinberg, Johannes; Siebert, Marlene; Katz, Toam Rahamim; Frings, Andreas; Mehlan, Juliane; Druchkiv, Vasyl; Bühren, Jens; Linke, Stephan.
in: J REFRACT SURG, Jahrgang 34, Nr. 12, 840, 12.10.2018.Publikationen: SCORING: Beitrag in Fachzeitschrift/Zeitung › SCORING: Zeitschriftenaufsatz › Forschung
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TY - JOUR
T1 - Tomographic and Biomechanical Scheimpflug Imaging for Keratoconus Characterization: A Validation of Current Indices
AU - Steinberg, Johannes
AU - Siebert, Marlene
AU - Katz, Toam Rahamim
AU - Frings, Andreas
AU - Mehlan, Juliane
AU - Druchkiv, Vasyl
AU - Bühren, Jens
AU - Linke, Stephan
PY - 2018/10/12
Y1 - 2018/10/12
N2 - PURPOSE:To analyze the potential benefit of the newly developed Tomography and Biomechanical Index (TBI) for early keratoconus screening.METHODS:In this retrospective study, the discriminatory power of the corneal tomography Belin/Ambrósio Enhanced Ectasia Display (BAD-D) index and the newly developed Corvis Biomechanical Index (CBI) and TBI to differentiate between normal eyes, manifest keratoconus eyes (KCE), very asymmetric keratoconus eyes with ectasia (VAE-E), and their fellow eyes with either regular topography (VAE-NT) or regular topography and tomography (VAE-NTT) were analyzed by applying the t test (for normal distribution), Wilcoxon matched-pairs test (if not normally distributed), and receiver operating characteristic curve (ROC). The DeLong test was used to compare the area under the ROC (AUROC). Further, the cut-offs of the analyzed indices presented in a study by Ambrósio et al. from 2017 were applied in the study population to enable a cross-validation in an independent study population.RESULTS:All indices demonstrated a high discriminative power when comparing normal and advanced keratoconus, which decreased when comparing normal and VAE-NT eyes and further when analyzing normal versus VAE-NTT eyes. The difference between the AUROCs reached a statistically significant level when comparing TBI versus BAD-D analyzing normal versus all included keratoconic eyes (P = .02). The TBI presented with the highest AUROCs throughout all conducted analyses when comparing different keratoconus stages, although not reaching a statistically significant level. Applying the cut-offs presented by Ambrósio et al. to differentiate between normal and VAE-NT in the study population, the accuracy was reproducible (accuracy in our study population with an optimized TBI cut-off: 0.72, with the cut-off defined by Ambrósio et al. 0.67).CONCLUSIONS:The TBI enables karatoconus screening in topographical and tomographical regular keratoconic eyes. To further improve the screening accuray, prospective studies should be conducted.
AB - PURPOSE:To analyze the potential benefit of the newly developed Tomography and Biomechanical Index (TBI) for early keratoconus screening.METHODS:In this retrospective study, the discriminatory power of the corneal tomography Belin/Ambrósio Enhanced Ectasia Display (BAD-D) index and the newly developed Corvis Biomechanical Index (CBI) and TBI to differentiate between normal eyes, manifest keratoconus eyes (KCE), very asymmetric keratoconus eyes with ectasia (VAE-E), and their fellow eyes with either regular topography (VAE-NT) or regular topography and tomography (VAE-NTT) were analyzed by applying the t test (for normal distribution), Wilcoxon matched-pairs test (if not normally distributed), and receiver operating characteristic curve (ROC). The DeLong test was used to compare the area under the ROC (AUROC). Further, the cut-offs of the analyzed indices presented in a study by Ambrósio et al. from 2017 were applied in the study population to enable a cross-validation in an independent study population.RESULTS:All indices demonstrated a high discriminative power when comparing normal and advanced keratoconus, which decreased when comparing normal and VAE-NT eyes and further when analyzing normal versus VAE-NTT eyes. The difference between the AUROCs reached a statistically significant level when comparing TBI versus BAD-D analyzing normal versus all included keratoconic eyes (P = .02). The TBI presented with the highest AUROCs throughout all conducted analyses when comparing different keratoconus stages, although not reaching a statistically significant level. Applying the cut-offs presented by Ambrósio et al. to differentiate between normal and VAE-NT in the study population, the accuracy was reproducible (accuracy in our study population with an optimized TBI cut-off: 0.72, with the cut-off defined by Ambrósio et al. 0.67).CONCLUSIONS:The TBI enables karatoconus screening in topographical and tomographical regular keratoconic eyes. To further improve the screening accuray, prospective studies should be conducted.
U2 - 10.3928/1081597X-20181012-01
DO - 10.3928/1081597X-20181012-01
M3 - SCORING: Journal article
VL - 34
JO - J REFRACT SURG
JF - J REFRACT SURG
SN - 1081-597X
IS - 12
M1 - 840
ER -