Corneal Backscatter, Pachymetric Indices, and Ectasia Indices for the Assessment of Fuchs Endothelial Corneal Dystrophy.

IF 1.9 3区医学 Q2 OPHTHALMOLOGY

Cornea Pub Date : 2025-04-01 Epub Date: 2024-05-28 DOI:10.1097/ICO.0000000000003577

Sanjay V Patel, David O Hodge, Keith H Baratz

{"title":"Corneal Backscatter, Pachymetric Indices, and Ectasia Indices for the Assessment of Fuchs Endothelial Corneal Dystrophy.","authors":"Sanjay V Patel, David O Hodge, Keith H Baratz","doi":"10.1097/ICO.0000000000003577","DOIUrl":null,"url":null,"abstract":"Purpose: To determine whether corneal backscatter, pachymetric indices, and ectasia indices derived from Scheimpflug tomography can identify Fuchs endothelial corneal dystrophy (FECD) corneas with abnormal tomography, the relationships between these parameters and tomographic edema in FECD, and if these parameters help predict improvement in central corneal thickness (CCT) after Descemet membrane endothelial keratoplasty (DMEK).Methods: Tomography maps of 132 eyes of 80 subjects with FECD were analyzed to determine how backscatter, pachymetric, and ectasia parameters compared with the instrument's normative database and if any predicted tomographic edema. Tomography maps from a separate group undergoing DMEK were split into derivation (48 eyes of 39 subjects) and validation (45 eyes of 41 subjects) subgroups to derive a predictive model of improvement in CCT after DMEK. Backscatter, pachymetric, and ectasia parameters were incorporated to determine if the model could be enhanced.Results: Among all ectasia, pachymetric, and backscatter parameters, at best only 65% of FECD corneas with definite tomographic edema could be identified based on the instrument's normative database. Among all parameters individually, the highest sensitivity for detecting tomographic edema was 77%. Anterior and mid-corneal backscatter featured in a model predicting improvement in CCT after DMEK with high performance in derivation (R 2 = 0.79; 95% confidence interval, 0.65-0.87) and validation (R 2 = 0.72; 95% confidence interval, 0.52-0.83) subgroups.Conclusions: The Scheimpflug camera software program could not reliably detect abnormal tomography in FECD from corneal backscatter, pachymetric indices, or ectasia indices. Corneal backscatter contributes to, but does not enhance, a predictive model of improvement in CCT after DMEK.","PeriodicalId":10710,"journal":{"name":"Cornea","volume":" ","pages":"427-434"},"PeriodicalIF":1.9000,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"Cornea","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.1097/ICO.0000000000003577","RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"2024/5/28 0:00:00","PubModel":"Epub","JCR":"Q2","JCRName":"OPHTHALMOLOGY","Score":null,"Total":0}

引用次数: 0

Abstract

Purpose: To determine whether corneal backscatter, pachymetric indices, and ectasia indices derived from Scheimpflug tomography can identify Fuchs endothelial corneal dystrophy (FECD) corneas with abnormal tomography, the relationships between these parameters and tomographic edema in FECD, and if these parameters help predict improvement in central corneal thickness (CCT) after Descemet membrane endothelial keratoplasty (DMEK).

Methods: Tomography maps of 132 eyes of 80 subjects with FECD were analyzed to determine how backscatter, pachymetric, and ectasia parameters compared with the instrument's normative database and if any predicted tomographic edema. Tomography maps from a separate group undergoing DMEK were split into derivation (48 eyes of 39 subjects) and validation (45 eyes of 41 subjects) subgroups to derive a predictive model of improvement in CCT after DMEK. Backscatter, pachymetric, and ectasia parameters were incorporated to determine if the model could be enhanced.

Results: Among all ectasia, pachymetric, and backscatter parameters, at best only 65% of FECD corneas with definite tomographic edema could be identified based on the instrument's normative database. Among all parameters individually, the highest sensitivity for detecting tomographic edema was 77%. Anterior and mid-corneal backscatter featured in a model predicting improvement in CCT after DMEK with high performance in derivation (R 2 = 0.79; 95% confidence interval, 0.65-0.87) and validation (R 2 = 0.72; 95% confidence interval, 0.52-0.83) subgroups.

Conclusions: The Scheimpflug camera software program could not reliably detect abnormal tomography in FECD from corneal backscatter, pachymetric indices, or ectasia indices. Corneal backscatter contributes to, but does not enhance, a predictive model of improvement in CCT after DMEK.

查看原文本刊更多论文

用于评估福氏内皮性角膜营养不良症的角膜反向散射、厚度指数和外伤指数。

目的：确定从 Scheimpflug 层析成像中得出的角膜反向散射、厚度指数和外生殖器指数是否能识别层析成像异常的福氏内皮角膜营养不良症（FECD）角膜，这些参数与 FECD 角膜层析水肿之间的关系，以及这些参数是否有助于预测 Descemet 膜内皮角膜移植术（DMEK）后中央角膜厚度（CCT）的改善情况：对 80 名 FECD 患者 132 只眼睛的断层扫描图进行分析，以确定背向散射、测厚和外生殖器参数与仪器标准数据库的比较情况，以及是否有任何参数可预测断层扫描水肿。接受 DMEK 的另一组患者的断层成像图被分成推导（39 名受试者的 48 只眼睛）和验证（41 名受试者的 45 只眼睛）两组，以得出 DMEK 后 CCT 改善的预测模型。结果显示：在所有外生殖器中，瞳孔散射参数、瞳孔厚度参数和外生殖器参数是最重要的：结果：在所有外生殖器、角膜厚度和背向散射参数中，根据仪器的标准数据库，最多只能确定 65% 的 FECD 角膜有明确的断层水肿。在所有参数中，检测断层水肿的灵敏度最高，为 77%。角膜前部和中部的反向散射是预测DMEK术后CCT改善情况的模型特征，在推导（R2=0.79；95%置信区间，0.65-0.87）和验证（R2=0.72；95%置信区间，0.52-0.83）亚组中表现优异：Scheimpflug照相机软件程序无法从角膜后散射、角膜厚度指数或外生殖器指数中可靠地检测出FECD的异常断层扫描。角膜反向散射有助于但并不能增强DMEK术后CCT改善的预测模型。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

求助全文

约1分钟内获得全文求助全文

来源期刊

Cornea 医学-眼科学

CiteScore

5.20

自引率

10.70%

发文量

354

审稿时长

3-6 weeks

期刊介绍： For corneal specialists and for all general ophthalmologists with an interest in this exciting subspecialty, Cornea brings together the latest clinical and basic research on the cornea and the anterior segment of the eye. Each volume is peer-reviewed by Cornea''s board of world-renowned experts and fully indexed in archival format. Your subscription brings you the latest developments in your field and a growing library of valuable professional references. Sponsored by The Cornea Society which was founded as the Castroviejo Cornea Society in 1975.