New Keratoconus Grading System Based on OCT: Threshold Adjustment for a Swept-Source OCT.

IF 2.6 3区医学 Q2 OPHTHALMOLOGY

Journal of cataract and refractive surgery Pub Date : 2025-03-03 DOI:10.1097/j.jcrs.0000000000001640

Nan-Ji Lu, Frederik Raiskup, Lutz E Pillunat, Qin-Mei Wang, Le-Le Cui, Robert Herber

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引用次数: 0

Abstract

Purpose: To assess the performance of the STEP keratoconus (KC) grading system using swept-source (SS)-OCT, and to compare the relative performance of SS-OCT and spectral domain (SD)-OCT for thickness measurements.

Setting: University hospitals in Germany and China.

Designs: Retrospective case-control study.

Methods: Rotating Scheimpflug Tomography (RSC, Pentacam) and SS-OCT (ANTERION) were used to examine 152 normal and 314 KC eyes from a German cohort; The STEP system (stroma thinnest thickness [ST] and epithelium standard deviation [EP]) was generated in SS-OCT and compared with RSC ABC system. Pentacam and SD-OCT (RTVue-XR) data from a Chinese cohort of 236 normal and 331 KC eyes were utilized to indirectly assess inter-device agreement between SS-OCT and SD-OCT using Bland-Altman plots and linear regression. Optimized thresholds for STEP 'ST' were determined for SS-OCT.

Results: In normal eyes, STEP 'ST' agreement with RSC 'C' was 91.45%, dropping to 28.98% in KC eyes. STEP 'EP' showed 58.55% and 60.53% agreement with RSC 'A' and 'B' in normal eyes, and 36.62% and 52.87% in KC eyes, respectively. SS-OCT's ST values were estimated to be higher than those of SD-OCT (estimated mean difference = 23.18 and 20.91 μm in the normal and KC eyes, respectively). Adjusted threshold of STEP 'ST' for SS-OCT was proposed.

Conclusions: SS-OCT's STEP 'EP' aligned well with RSC ABC system, while thresholds for SS-OCT's STEP 'ST' required adjustment for more accurate clinical application. These findings highlight important considerations for thickness measurement discrepancies between SS-OCT and SD-OCT, with broader implications for future clinical practice and research.

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来源期刊

$Journal of cataract and refractive surgery$

Journal of cataract and refractive surgery 医学-外科

CiteScore

5.60

自引率

14.30%

发文量

259

审稿时长

8.5 weeks

期刊介绍： The Journal of Cataract & Refractive Surgery (JCRS), a preeminent peer-reviewed monthly ophthalmology publication, is the official journal of the American Society of Cataract and Refractive Surgery (ASCRS) and the European Society of Cataract and Refractive Surgeons (ESCRS). JCRS publishes high quality articles on all aspects of anterior segment surgery. In addition to original clinical studies, the journal features a consultation section, practical techniques, important cases, and reviews as well as basic science articles.