New keratoconus staging system based on OCT.

Autor:	Lu NJ; From 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)., Hafezi F, Koppen C, Alió Del Barrio JL, Aslanides IM, Awwad ST, Ní Dhubhghaill S, Pineda R 2nd, Torres-Netto EA, Wang L, Chen SH, Cui LL, Rozema JJ
Jazyk:	angličtina
Zdroj:	Journal of cataract and refractive surgery [J Cataract Refract Surg] 2023 Nov 01; Vol. 49 (11), pp. 1098-1105.
DOI:	10.1097/j.jcrs.0000000000001276
Abstrakt:	Purpose: To establish a numerical spectral-domain optical coherence tomography (SD-OCT)-based keratoconus (KC) staging system and compare it with existing KC staging systems. Setting: Eye Hospital of Wenzhou Medical University, Wenzhou, China. Designs: Retrospective case-control study. Methods: Scheimpflug tomography, air-puff tonometry, and SD-OCT were performed on 236 normal and 331 KC eyes. All SD-OCT-derived parameters of the corneal epithelium and stroma were evaluated based on their receiver operating characteristic (ROC) curves, area under the curve (AUC), sensitivity, and specificity to discriminate between normal and KC eyes. The best performing parameters were subsequently used to create an OCT-based staging system, which was compared with existing tomographic and biomechanical staging systems. Results: 236 eyes from 236 normal patients and 331 eyes from 331 KC patients of different stages were included. The highest ranked AUC ROC SD-OCT parameters, derived from stroma and epithelium, were stroma overall minimum thickness (ST: AUC 0.836, sensitivity 90%, specificity 67%) and epithelium overall SD (EP: AUC 0.835, sensitivity 75%, specificity 78%). A numerical SD-OCT staging system called STEP including 2 parameters-"ST" and "EP"-with 5 stages was proposed. Conclusions: The new SD-OCT-based KC staging system is the first to take the epithelium with its sublayer stroma information into account, showing a strong agreement to the existing staging systems. This system could be incorporated into daily practice, potentially leading to an overall improvement in KC treatment and follow-up management. (Copyright © 2023 The Author(s). Published by Wolters Kluwer Health, Inc. on behalf of ASCRS and ESCRS.)
Databáze:	MEDLINE
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