Accuracy of Scheimpflug-derived corneal biomechanical and tomographic indices for detecting subclinical and mild keratectasia in a South Asian population
Accuracy of Scheimpflug-derived corneal biomechanical and tomographic indices for detecting subclinical and mild keratectasia in a South Asian population
复制标题
DOI：
10.1016/j.jcrs.2018.10.030
复制
发表时间：
2019-03-01
影响因子：
2.8
通讯作者：
Ambrosio, Renato, Jr.
中科院分区：
文献类型：
--
作者：
Kataria, Pratik;Padmanabhan, Prema;Ambrosio, Renato, Jr.
目的：测试 Belin-Ambrosio 偏差指数 (BAD-D)、刚度参数 A(1) (SPA(1))、Corvis 生物力学指数 (CBI) 以及断层扫描和生物力学指数 (TBI) 评估的预测准确性，以区分亚临床和轻度圆锥角膜眼睛与正常眼睛。设置：印度金奈 Sankara Nethralaya 医学研究基金会。设计：回顾性病例系列。方法：在这项横断面临床研究对以下3组眼睛进行了分析：非常不对称扩张伴正常地形（very asymmetry-normal topography）、轻度圆锥角膜和正常对照。所有眼睛均进行了角膜地形图 (TMS-IV)、Scheimpflug 断层扫描 (Pentacam HR) 和动态 Scheimpflug 生物力学分析 (Corvis ST) 的综合评估。结果测量为 BAD-D、SPA(1)、CBI 和 TBI。进行受试者工作特征（ROC）曲线分析，以确定每个参数区分亚临床或轻度圆锥角膜和对照眼的预测准确性。结果：非常不对称-正常地形和正常对照比较的曲线下面积（AUC）ROC值为0.81（BAD-D）、0.76（SPA（1））、0.78（CBI）和0.90（TBI）。 TBI（使用截止值 0.16）显示出最高的诊断准确性 (85%)，敏感性为 84%，特异性为 86%。轻度圆锥角膜和正常对照比较的 AUC ROC 值为 0.998 (BAD-D)、0.91 (SPA(1))、0.97 (CBI) 和 0.999 (TBI)。 TBI（截止值为 0.63）显示出最高的准确度（99.5%），灵敏度为 99%，特异性为 100%。 TBI 还显示出与正常眼和圆锥角膜眼的平均角膜曲率、生物力学校正眼压和中央角膜厚度的相关性最弱。结论：TBI 能够最好地区分轻度扩张眼和正常眼，并且与生物力学混杂因素的相关性最弱，从而强化了 TBI 代表角膜生物力学敏感性的假设。 (C) 2018 ASCRS 和 ESCRS
Purpose: To test the predictive accuracy of the Belin-Ambrosio deviation index (BAD-D), the stiffness parameter A(1) (SPA(1)), the Corvis biomechanical index (CBI), and the tomographic and biomechanical index (TBI) assessments for distinguishing subclinical and mild keratoconic eyes from normal eyes.Setting: Medical Research Foundation, Sankara Nethralaya, Chennai, India.Design: Retrospective case series.Method: In this cross-sectional clinical study, the following 3 groups of eyes were analyzed: very asymmetric ectasia with normal topography (very asymmetric-normal topography), mild keratoconus, and normal control. All eyes had comprehensive assessment with corneal topography (TMS-IV), Scheimpflug tomography (Pentacam HR), and dynamic Scheimpflug biomechanical analysis (Corvis ST). The outcome measures were the BAD-D, SPA(1), CBI, and TBI. Receiver operating characteristic (ROC) curve analysis was performed to determine each parameter's predictive accuracy in distinguishing between eyes with subclinical or mild keratoconus and control eyes.Results: The area under the curve (AUC) ROC values for the very asymmetric-normal topography and normal control comparison were 0.81 (BAD-D), 0.76 (SPA(1)), 0.78 (CBI), and 0.90 (TBI). The TBI (using cutoff value 0.16) showed the highest diagnostic accuracy (85%), with 84% sensitivity and 86% specificity. The AUC ROC values for the mild keratoconus and normal control comparison were 0.998 (BAD-D), 0.91 (SPA(1)), 0.97 (CBI), and 0.999 (TBI). The TBI (with a 0.63 cutoff) showed the highest accuracy (99.5%), with 99% sensitivity and 100% specificity. The TBI also showed the weakest correlation with mean keratometry, biomechanically corrected intraocular pressure, and central corneal thickness in normal eyes and keratoconic eyes.Conclusions: The TBI best distinguished eyes with mild ectasia from normal eyes and had the weakest correlation with biomechanical confounding factors, reinforcing the hypothesis that the TBI represents corneal biomechanical susceptibility. (C) 2018 ASCRS and ESCRS