TY - JOUR
T1 - Distinguishing Keratoconic Eyes and Healthy Eyes Using Ultrahigh-Resolution Optical Coherence Tomography–Based Corneal Epithelium Thickness Mapping
AU - Pircher, Niklas
AU - Schwarzhans, Florian
AU - Holzer, Stephan
AU - Lammer, Jan
AU - Schmidl, Doreen
AU - Bata, Ahmed M.
AU - Werkmeister, Renè M.
AU - Seidel, Gerald
AU - Garhöfer, Gerhard
AU - Gschließer, Andreas
AU - Schmetterer, Leopold
AU - Schmidinger, Gerald
N1 - Publisher Copyright:
© 2018 Elsevier Inc.
PY - 2018/5
Y1 - 2018/5
N2 - Purpose: To find differences in epithelial thickness (ET) maps of eyes with keratoconus (KC) and healthy eyes. Design: Institutional cross-sectional study. Methods: In this study 40 keratoconic eyes and 76 healthy eyes were scanned using a custom-built ultrahigh-resolution optical coherence tomography system. Automated segmentation ET maps with 17 subsectors were calculated (central, temporal inferior, temporal superior, nasal inferior, and nasal superior area). The thinnest point of the epithelium (minET), the thickest point of the epithelium (maxET), and the thinnest point diagonally opposing the thickest point (ETmax/op) were additional parameters. Ratios were calculated as follows: minET/diagonally opposing point (R1), maxET/diagonally opposing point (R2), inferior temporal area/superior nasal area (RTI/NS), and inferior/superior hemisphere (RI/S). Furthermore, collected parameters were analyzed regarding their diagnostic accuracy (area under the curve; AUC). Results: Statistically significant differences were as follows: central ET, 46.25 ± 2.56/50.91 ± 1.66; minET, 38.50 ± 2.10/46.79 ± 1.27; ETmax/op, 47.14 ± 2.45/49.60 ± 1.57; temporal inferior area: 43.93 ± 2.95/51.04 ± 1.51 (all mean ± standard deviation, μm); R1, 0.76 ± 0.09/0.93 ± 0.04; R2, 1.08 ± 0.04/1.21 ± 0.16; RTI/NS, 0.85 ± 0.08/1.02 ± 0.04; RI/S: 0.92 ± 0.07/0.99 ± 0.02. AUC values were R1: 0.979 (confidence interval [CI]: 0.957–1.000), RTI/NS: 0.977 (CI: 0.951–1.000), and minET: 0.928 (CI: 0.880–0.977). Conclusions: Epithelial thickness maps could clearly visualize different ET patterns. Parameters with the highest potential of diagnostic discrimination between eyes with KC and healthy eyes were, in descending order, R1, RTI/NS, and minET. Consequently, epithelial thickness irregularity and asymmetry seem to be the most promising diagnostic factor in terms of discriminating between keratoconic eyes and healthy eyes.
AB - Purpose: To find differences in epithelial thickness (ET) maps of eyes with keratoconus (KC) and healthy eyes. Design: Institutional cross-sectional study. Methods: In this study 40 keratoconic eyes and 76 healthy eyes were scanned using a custom-built ultrahigh-resolution optical coherence tomography system. Automated segmentation ET maps with 17 subsectors were calculated (central, temporal inferior, temporal superior, nasal inferior, and nasal superior area). The thinnest point of the epithelium (minET), the thickest point of the epithelium (maxET), and the thinnest point diagonally opposing the thickest point (ETmax/op) were additional parameters. Ratios were calculated as follows: minET/diagonally opposing point (R1), maxET/diagonally opposing point (R2), inferior temporal area/superior nasal area (RTI/NS), and inferior/superior hemisphere (RI/S). Furthermore, collected parameters were analyzed regarding their diagnostic accuracy (area under the curve; AUC). Results: Statistically significant differences were as follows: central ET, 46.25 ± 2.56/50.91 ± 1.66; minET, 38.50 ± 2.10/46.79 ± 1.27; ETmax/op, 47.14 ± 2.45/49.60 ± 1.57; temporal inferior area: 43.93 ± 2.95/51.04 ± 1.51 (all mean ± standard deviation, μm); R1, 0.76 ± 0.09/0.93 ± 0.04; R2, 1.08 ± 0.04/1.21 ± 0.16; RTI/NS, 0.85 ± 0.08/1.02 ± 0.04; RI/S: 0.92 ± 0.07/0.99 ± 0.02. AUC values were R1: 0.979 (confidence interval [CI]: 0.957–1.000), RTI/NS: 0.977 (CI: 0.951–1.000), and minET: 0.928 (CI: 0.880–0.977). Conclusions: Epithelial thickness maps could clearly visualize different ET patterns. Parameters with the highest potential of diagnostic discrimination between eyes with KC and healthy eyes were, in descending order, R1, RTI/NS, and minET. Consequently, epithelial thickness irregularity and asymmetry seem to be the most promising diagnostic factor in terms of discriminating between keratoconic eyes and healthy eyes.
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U2 - 10.1016/j.ajo.2018.02.006
DO - 10.1016/j.ajo.2018.02.006
M3 - Article
C2 - 29458037
AN - SCOPUS:85042916208
SN - 0002-9394
VL - 189
SP - 47
EP - 54
JO - American Journal of Ophthalmology
JF - American Journal of Ophthalmology
ER -