Corneal Vertical and Horizontal Thickness Profiles Generated by UHR-OCT for Suspected and Subclinical Keratoconus Diagnosis
Corneal Vertical and Horizontal Thickness Profiles Generated by UHR-OCT for Suspected and Subclinical Keratoconus Diagnosis
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DOI：
10.3928/1081597x-20210330-01
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发表时间：
2021-07-01
影响因子：
2.4
通讯作者：
Lu, Fan
中科院分区：
文献类型：
--
作者：
Hu, Liang;Li, Yong;Lu, Fan
目的：验证角膜垂直和水平厚度轮廓的诊断能力。方法：对25例确诊为圆锥角膜，63例可疑圆锥角膜，15例亚临床圆锥角膜，42例正常人进行横断面研究。用UHR-OCT测量角膜上皮、Bowman层和基质的垂直和水平厚度分布，诊断指标包括厚度分布比和基于它们的多元Logistic回归计算的多元判别函数。结果：角膜上皮垂直最大扩张指数和Bowman层水平最大扩张指数组成的函数能很好地区分亚临床圆锥角膜（AUC = 0.967）和可疑圆锥角膜（AUC = 0.932）与正常角膜。此外，当四个指标相结合时，亚临床圆锥角膜（AUC =0.984）和可疑圆锥角膜（AUC = 0.971）的诊断能力进一步增加。然而，二元和四元功能不能充分区分疑似亚临床圆锥角膜。结论：UHR-OCT生成的厚度指数从垂直和水平的角膜上皮和Bowman层的厚度分布显示了明显的诊断效果，在区分可疑和亚临床圆锥角膜从正常的眼睛。圆锥角膜的早期改变可能更倾向于角膜各亚层的厚度分布，而不是角膜厚度或地形图。
PURPOSE: To verify the diagnostic power of vertical and horizontal thickness profiles of the corneal. sublayers generated by ultra-high resolution optical coherence tomography (UHR=OCT) in subclinical and suspected keratoconus.METHODS: In this cross-sectional study, 25 eyes with confirmed keratoconus, 63 eyes with suspected keratoconus, 15 eyes with subclinical keratoconus, and 42 normal eyes were investigated. Vertical and horizontal thickness profiles of the corneal epithelium, Bowman's layer, and stroma were measured by UHR-OCT. Diagnostic indices included ratios of thickness distribution and multimeric discriminant functions calculated by multiple logistic regression based on them. Receiver operating characteristic curves were used to verify the predictive accuracy by the area under the curve (AUC).RESULTS: Function consisting of two indices (vertical maximum ectasia index of epithelium and horizontal maximum ectasia index of Bowman's layer) performed welt to discriminate subclinical keratoconus (AUC = 0.967) and suspected keratoconus (AUC = 0.932) from normal. In addition, when four indices were combined, the diagnostic power for subclinical keratoconus (AUC =0.984) and suspected keratoconus (AUC = 0.971) was further increased. However, both binary and quaternary functions could not adequately discriminate suspected from subclinical keratoconus.CONCLUSIONS: UHR-OCT-generated thickness indices from the vertical and horizontal thickness profiles of the corneal epithelium and Bowman's layer showed an evident diagnostic efficacy in discriminating suspected and subclinical keratoconus from normal eyes. The early changes in keratoconus might prefer thickness distribution in corneal sublayers rather than corneal thickness or topography.