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New keratoconus staging system based on OCT.

Nan-Ji Lu1, Farhad Hafezi, Carina Koppen

  • 1From the Faculty of Medicine and Health Sciences, University of Antwerp, Wilrijk, Belgium (Lu, Koppen, Ní Dhubhghaill, Rozema); National Clinical Research Center for Ocular Diseases, Eye Hospital, Wenzhou Medical University, Wenzhou, China (Lu, Hafezi, Aslanides, Chen, Cui); State Key Laboratory of Ophthalmology, Optometry and Visual Science, Eye Hospital, Wenzhou Medical University, Wenzhou, China (Lu, Chen, Cui); Department of Ophthalmology, West China Hospital, Sichuan University, Chengdu, Sichuan, China (Lu, Wang); ELZA Institute, Dietikon, Switzerland (Lu, Hafezi, Torres-Netto); Ocular Cell Biology Group, Center for Applied Biotechnology and Molecular Medicine, University of Zurich, Switzerland (Hafezi, Torres-Netto); Faculty of Medicine, University of Geneva, Geneva, Switzerland (Hafezi, Torres-Netto); Department of Ophthalmology, University of Southern California, Los Angeles, California (Hafezi); Department of Ophthalmology, Antwerp University Hospital, Edegem, Belgium (Koppen, Rozema); Division of Ophthalmology, School of Medicine, Universidad Miguel Hernández, Alicante, Spain (Alió del Barrio); Cornea, Cataract and Refractive Surgery Unit, Vissum (Miranza Group), Alicante, Spain (Alió del Barrio); Emmetropia Mediterranean Eye Institute, Heraklion, Crete, Greece (Aslanides); The American University of Beirut Medical Center, Beirut, Lebanon (Awwad); The Department of Ophthalmology, Brussels University Hospital, Brussels, Belgium (Ní Dhubhghaill); The faculty of Health Sciences and Pharmacy, Vrije Universiteit Brussel, Brussels, Belgium (Ní Dhubhghaill); Department of Ophthalmology, Massachusetts Eye and Ear and Harvard Medical School, Boston, Massachusetts (Pineda).

Journal of Cataract and Refractive Surgery
|August 2, 2023
PubMed
Summary
This summary is machine-generated.

A new spectral-domain optical coherence tomography (SD-OCT) staging system for keratoconus (KC) was developed. This system, incorporating corneal stroma and epithelium data, shows strong agreement with existing methods for improved KC management.

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Area of Science:

  • Ophthalmology
  • Medical Imaging
  • Corneal Diseases

Background:

  • Keratoconus (KC) is a progressive thinning of the cornea.
  • Accurate staging is crucial for effective management and treatment.
  • Existing staging systems lack comprehensive analysis of corneal layers.

Purpose of the Study:

  • To develop a novel numerical staging system for keratoconus using spectral-domain optical coherence tomography (SD-OCT).
  • To compare the efficacy of the new SD-OCT-based system against established tomographic and biomechanical staging methods.
  • To evaluate SD-OCT parameters for discriminating between normal and KC eyes.

Main Methods:

  • A retrospective case-control study involving 236 normal eyes and 331 KC eyes.
  • Analysis of SD-OCT, Scheimpflug tomography, and air-puff tonometry data.
  • Receiver operating characteristic (ROC) curve analysis to determine sensitivity and specificity of SD-OCT parameters.

Main Results:

  • SD-OCT parameters, including stroma overall minimum thickness (ST) and epithelium overall standard deviation (EP), demonstrated high diagnostic accuracy (AUC > 0.83).
  • A new 5-stage numerical staging system, STEP, was proposed, utilizing ST and EP parameters.
  • The STEP system showed strong agreement with existing keratoconus staging systems.

Conclusions:

  • The developed SD-OCT-based KC staging system (STEP) is the first to integrate epithelial and stromal data.
  • This novel system demonstrates significant agreement with current staging methods.
  • The STEP system has the potential for integration into clinical practice to enhance KC patient care and follow-up.