Subclinical keratoconus detection by pattern analysis of corneal and epithelial thickness maps with optical coherence tomography.
Subclinical keratoconus detection by pattern analysis of corneal and epithelial thickness maps with optical coherence tomography.
复制标题
DOI：
10.1016/j.jcrs.2015.09.021
复制
发表时间：
2016-02
影响因子：
2.8
通讯作者：
Huang D
中科院分区：
文献类型：
--
作者：
Li Y;Chamberlain W;Tan O;Brass R;Weiss JL;Huang D
利用傅里叶域光学相干断层扫描（OCT）分析角膜、上皮和间质厚度图，以筛查亚临床圆锥角膜。在美国有四个中心。横断面观察研究。对正常受试者的眼睛、亚临床圆锥角膜患者的眼睛和单侧圆锥角膜患者的正常眼睛进行了研究。角膜扫描使用26&thinsp；000 Hz傅里叶域OCT系统（RTVue）。正常受试者分为训练组和评估组。根据OCT数据计算角膜、上皮和间质厚度图和衍生的诊断指标，包括模式标准差（PSD）变量和基于厚测图的圆锥角膜风险评分。采用受试者工作特征曲线下面积（AUC）分析评价指标的诊断准确性。本研究包括83名正常人150只眼，32名亚临床圆锥角膜患者50只眼，1名单侧圆锥角膜患者1只眼。亚临床圆锥角膜的特征是角膜、上皮和间质在颞下变薄。亚临床角膜变形眼的角膜（P < 0.001）、上皮（P < 0.001）和间质（P = 0.049）厚度图的PSD值均显著高于正常组。PSD变量（厚测PSD， AUC = 0.941；上皮PSD， AUC = 0.985；间质PSD， AUC = 0.924）的诊断准确性明显高于基于厚测图的圆锥角膜风险评分（AUC = 0.735）。高分辨率傅里叶域OCT可以绘制角膜、上皮和间质厚度。使用PSD变量可以高精度地检测亚临床圆锥角膜的角膜和亚层厚度变化。这些新的诊断变量可能有助于早期圆锥角膜的发现。
To screen for subclinical keratoconus by analyzing corneal, epithelial, and stromal thickness map patterns with Fourier-domain optical coherence tomography (OCT). Four centers in the United States. Cross-sectional observational study. Eyes of normal subjects, subclinical keratoconus eyes, and the topographically normal eye of a unilateral keratoconus patient were studied. Corneas were scanned using a 26 000 Hz Fourier-domain OCT system (RTVue). Normal subjects were divided into training and evaluation groups. Corneal, epithelial, and stromal thickness maps and derived diagnostic indices, including pattern standard deviation (PSD) variables and pachymetric map–based keratoconus risk scores were calculated from the OCT data. Area under the receiver operating characteristic curve (AUC) analysis was used to evaluate the diagnostic accuracy of the indices. The study comprised 150 eyes of 83 normal subjects, 50 subclinical keratoconus eyes of 32 patients, and 1 topographically normal eye of a unilateral keratoconus patient. Subclinical keratoconus was characterized by inferotemporal thinning of the cornea, epithelium, and stroma. The PSD values for corneal (P < .001), epithelial (P < .001), and stromal (P = .049) thickness maps were all significantly higher in subclinical keratoconic eyes than in the normal group. The diagnostic accuracy was significantly higher for PSD variables (pachymetric PSD, AUC = 0.941; epithelial PSD, AUC = 0.985; stromal PSD, AUC = 0.924) than for the pachymetric map–based keratoconus risk score (AUC = 0.735). High-resolution Fourier-domain OCT could map corneal, epithelial, and stromal thicknesses. Corneal and sublayer thickness changes in subclinical keratoconus could be detected with high accuracy using PSD variables. These new diagnostic variables might be useful in the detection of early keratoconus.