{"title":"The Combined Utilization of Epithelial Thickness and Tomographic Parameters in Keratoconus Detection.","authors":"Abdelrahman Salman, Mayank Nanavaty, Rana Omran, Marwan Ghabra, Obeda Kailani, Rafea Shaaban, Taym Darwish, Buraa Kubaisi, Zein Baradi, Mohamed Khallouf, Omar Badla","doi":"10.1155/joph/6647993","DOIUrl":null,"url":null,"abstract":"<p><p><b>Purpose:</b> To evaluate the performance of the anterior segment optical coherence tomography (AS-OCT) and Scheimpflug-Placido tomographic (SPT) indices in differentiating suspect keratoconus (SKC) from normal (N). <b>Methods:</b> In this cross-sectional study, one eye of each patient was scanned on AS-OCT and SPT. Following, 5 regression analysis models were developed: Model 1: combined AS-OCT corneal thickness (CT); Model 2: combined AS-OCT epithelial thickness (ET); Model 3: Models 1 + 2; Model 4: SPT indices (symmetry index front [SIf], symmetry index back [SIb], keratoconus vertex back [KVb], and minimum CT [ThkMin]); Model 5: Models 3 + 4. The areas under the curve (AUC) of receiver operator characteristic (ROC) curves were compared across groups to estimate their performance accuracy. <b>Results:</b> Two hundred and five N eyes, 56 SKC eyes, and 89 keratoconus (KC) eyes were scanned with AS-OCT and SPT. For Models 1 and 2, no individual metric yielded an AUC > 0.84. For Model 3, the AUC was 0.96 (R2 Nagelkerke: 0.69) with 90.28% cases correctly identified as SKC. For Model 4, the AUC was 0.99 (R2 Nagelkerke: 0.87), with 95.58% of cases correctly classified as SKC. For Model 5, the diagnostic accuracy did not improve compared to Model 4. <b>Conclusion:</b> Both combined AS-OCT indices and combined SPT indices provided excellent diagnostic power to differentiate SKC from N eyes. The combined SPT model showed a superior value compared to the AS-OCT model. Furthermore, combined AS-OCT and SPT data did not perform better than the combined SPT data alone.</p>","PeriodicalId":16674,"journal":{"name":"Journal of Ophthalmology","volume":"2025 ","pages":"6647993"},"PeriodicalIF":1.8000,"publicationDate":"2025-03-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11936534/pdf/","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"Journal of Ophthalmology","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.1155/joph/6647993","RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"2025/1/1 0:00:00","PubModel":"eCollection","JCR":"Q3","JCRName":"OPHTHALMOLOGY","Score":null,"Total":0}
引用次数: 0
Abstract
Purpose: To evaluate the performance of the anterior segment optical coherence tomography (AS-OCT) and Scheimpflug-Placido tomographic (SPT) indices in differentiating suspect keratoconus (SKC) from normal (N). Methods: In this cross-sectional study, one eye of each patient was scanned on AS-OCT and SPT. Following, 5 regression analysis models were developed: Model 1: combined AS-OCT corneal thickness (CT); Model 2: combined AS-OCT epithelial thickness (ET); Model 3: Models 1 + 2; Model 4: SPT indices (symmetry index front [SIf], symmetry index back [SIb], keratoconus vertex back [KVb], and minimum CT [ThkMin]); Model 5: Models 3 + 4. The areas under the curve (AUC) of receiver operator characteristic (ROC) curves were compared across groups to estimate their performance accuracy. Results: Two hundred and five N eyes, 56 SKC eyes, and 89 keratoconus (KC) eyes were scanned with AS-OCT and SPT. For Models 1 and 2, no individual metric yielded an AUC > 0.84. For Model 3, the AUC was 0.96 (R2 Nagelkerke: 0.69) with 90.28% cases correctly identified as SKC. For Model 4, the AUC was 0.99 (R2 Nagelkerke: 0.87), with 95.58% of cases correctly classified as SKC. For Model 5, the diagnostic accuracy did not improve compared to Model 4. Conclusion: Both combined AS-OCT indices and combined SPT indices provided excellent diagnostic power to differentiate SKC from N eyes. The combined SPT model showed a superior value compared to the AS-OCT model. Furthermore, combined AS-OCT and SPT data did not perform better than the combined SPT data alone.
期刊介绍:
Journal of Ophthalmology is a peer-reviewed, Open Access journal that publishes original research articles, review articles, and clinical studies related to the anatomy, physiology and diseases of the eye. Submissions should focus on new diagnostic and surgical techniques, instrument and therapy updates, as well as clinical trials and research findings.