Aydano P Machado, Louise Pellegrino G Esporcatte, Marcella Q Salomão, Bernardo T Lopes, João Marcelo A G Lyra, Renato Ambrósio
{"title":"相关组织改变（RTA）指数的发展和验证：应用人工智能评估激光视力矫正对结构的影响。","authors":"Aydano P Machado, Louise Pellegrino G Esporcatte, Marcella Q Salomão, Bernardo T Lopes, João Marcelo A G Lyra, Renato Ambrósio","doi":"10.1007/s40123-025-01206-y","DOIUrl":null,"url":null,"abstract":"<p><strong>Introduction: </strong>A retrospective case-control study was carried out to develop a predictive computational model to objectively and accurately represent the impact of laser vision correction (LVC) on the corneal structure. This study involved data from 3278 eyes (1690 patients) that remained stable after refractive surgery and 105 eyes (66 patients) that developed postoperative ectasia.</p><p><strong>Methods: </strong>An artificial intelligence-based machine learning approach was used to create a predictive model for the impact of corneal refractive surgery. The development process was based on the practice of knowledge discovery in databases (KDD) and addressed each step, including data selection, preprocessing, data transformation, data mining, and model evaluation. To evaluate the predictive model output, we analyzed the receiver operating characteristic (ROC) curves to determine the area under the curve (AUC) and the optimal cutoff points, as well as sensitivity and specificity.</p><p><strong>Results: </strong>The minimal pachymetry was superior to central (apex) pachymetry for all calculations. The Relational Tissue Altered (RTA) showed the highest AUC performance, with area under the curve (AUC) values of 0.913. These AUC values were significantly higher (according to the DeLong test) than those obtained with Residual Stromal Bed (RSB) values of 0.832 and 0.825 (apex), and Percent Tissue Altered (PTA) values of 0.805 (minimum (min)) and 0.800 (apex). RTA demonstrated a sensitivity of 76.0% (95% confidence interval (CI) 68.8-83.2%) and a specificity of 89.2% (95% CI 86.2-92.2%). PTA min showed a sensitivity of 66.0% (95% CI 58.0-74.0%) and a specificity of 85.4% (95% CI 82.0-88.8%).</p><p><strong>Conclusions: </strong>The Relational Tissue Altered (RTA) index provides an objective and data-driven measure of the structural impact induced by laser vision correction (LVC) on the cornea. Compared with traditional parameters such as Residual Stromal Bed (RSB) and Percent Tissue Altered (PTA), which were not originally designed to quantify biomechanical disruption, RTA demonstrated superior performance in characterizing surgical impact. Although not developed as a standalone ectasia predictor, RTA offers unique value when integrated with preoperative assessments of intrinsic corneal susceptibility, including topometric, tomographic, and biomechanical metrics. This synergistic approach holds promise for enhancing risk stratification, refining surgical planning, and advancing the safety and personalization of refractive surgery.</p>","PeriodicalId":19623,"journal":{"name":"Ophthalmology and Therapy","volume":" ","pages":""},"PeriodicalIF":2.6000,"publicationDate":"2025-07-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":"{\"title\":\"Development and Validation of the Relational Tissue Altered (RTA) Index: Applied Artificial Intelligence for the Assessment of Structural Impact from Laser Vision Correction.\",\"authors\":\"Aydano P Machado, Louise Pellegrino G Esporcatte, Marcella Q Salomão, Bernardo T Lopes, João Marcelo A G Lyra, Renato Ambrósio\",\"doi\":\"10.1007/s40123-025-01206-y\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><strong>Introduction: </strong>A retrospective case-control study was carried out to develop a predictive computational model to objectively and accurately represent the impact of laser vision correction (LVC) on the corneal structure. This study involved data from 3278 eyes (1690 patients) that remained stable after refractive surgery and 105 eyes (66 patients) that developed postoperative ectasia.</p><p><strong>Methods: </strong>An artificial intelligence-based machine learning approach was used to create a predictive model for the impact of corneal refractive surgery. The development process was based on the practice of knowledge discovery in databases (KDD) and addressed each step, including data selection, preprocessing, data transformation, data mining, and model evaluation. To evaluate the predictive model output, we analyzed the receiver operating characteristic (ROC) curves to determine the area under the curve (AUC) and the optimal cutoff points, as well as sensitivity and specificity.</p><p><strong>Results: </strong>The minimal pachymetry was superior to central (apex) pachymetry for all calculations. The Relational Tissue Altered (RTA) showed the highest AUC performance, with area under the curve (AUC) values of 0.913. These AUC values were significantly higher (according to the DeLong test) than those obtained with Residual Stromal Bed (RSB) values of 0.832 and 0.825 (apex), and Percent Tissue Altered (PTA) values of 0.805 (minimum (min)) and 0.800 (apex). RTA demonstrated a sensitivity of 76.0% (95% confidence interval (CI) 68.8-83.2%) and a specificity of 89.2% (95% CI 86.2-92.2%). PTA min showed a sensitivity of 66.0% (95% CI 58.0-74.0%) and a specificity of 85.4% (95% CI 82.0-88.8%).</p><p><strong>Conclusions: </strong>The Relational Tissue Altered (RTA) index provides an objective and data-driven measure of the structural impact induced by laser vision correction (LVC) on the cornea. Compared with traditional parameters such as Residual Stromal Bed (RSB) and Percent Tissue Altered (PTA), which were not originally designed to quantify biomechanical disruption, RTA demonstrated superior performance in characterizing surgical impact. Although not developed as a standalone ectasia predictor, RTA offers unique value when integrated with preoperative assessments of intrinsic corneal susceptibility, including topometric, tomographic, and biomechanical metrics. This synergistic approach holds promise for enhancing risk stratification, refining surgical planning, and advancing the safety and personalization of refractive surgery.</p>\",\"PeriodicalId\":19623,\"journal\":{\"name\":\"Ophthalmology and Therapy\",\"volume\":\" \",\"pages\":\"\"},\"PeriodicalIF\":2.6000,\"publicationDate\":\"2025-07-19\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Ophthalmology and Therapy\",\"FirstCategoryId\":\"3\",\"ListUrlMain\":\"https://doi.org/10.1007/s40123-025-01206-y\",\"RegionNum\":3,\"RegionCategory\":\"医学\",\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"Q2\",\"JCRName\":\"OPHTHALMOLOGY\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Ophthalmology and Therapy","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.1007/s40123-025-01206-y","RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q2","JCRName":"OPHTHALMOLOGY","Score":null,"Total":0}
引用次数: 0
摘要
通过回顾性病例对照研究，建立预测计算模型，客观准确地反映激光视力矫正（LVC）对角膜结构的影响。这项研究的数据来自3278只（1690名患者）屈光手术后保持稳定的眼睛和105只（66名患者）术后出现扩张的眼睛。方法：采用基于人工智能的机器学习方法建立角膜屈光手术影响的预测模型。开发过程基于数据库中知识发现（KDD）的实践，并解决了每个步骤，包括数据选择、预处理、数据转换、数据挖掘和模型评估。为了评估预测模型的输出，我们分析了受试者工作特征（ROC）曲线，以确定曲线下面积（AUC）和最佳截止点，以及灵敏度和特异性。结果：最小测厚术优于中央（顶点）测厚术。相关组织变异（RTA）的AUC表现最好，曲线下面积（AUC）为0.913。这些AUC值（根据DeLong检验）显著高于残余基质床（RSB）值0.832和0.825（顶点），以及组织改变百分比（PTA）值0.805（最小（min））和0.800（顶点）。RTA的敏感性为76.0%(95%可信区间（CI） 68.8-83.2%)，特异性为89.2% （95% CI 86.2-92.2%）。PTA min的敏感性为66.0% (95% CI 58.0 ~ 74.0%)，特异性为85.4% （95% CI 82.0 ~ 88.8%）。结论：相关组织改变（RTA）指数是衡量激光视力矫正（LVC）对角膜结构影响的客观、数据驱动的指标。与传统参数（如残余基质床（RSB）和组织改变百分比（PTA））相比，RTA在表征手术影响方面表现优异，这些参数最初并非用于量化生物力学破坏。虽然RTA并不是一个独立的扩张预测指标，但当RTA与术前角膜固有易感性评估（包括地形测量、层析成像和生物力学指标）相结合时，它具有独特的价值。这种协同方法有望加强风险分层，完善手术计划，提高屈光手术的安全性和个性化。
Development and Validation of the Relational Tissue Altered (RTA) Index: Applied Artificial Intelligence for the Assessment of Structural Impact from Laser Vision Correction.
Introduction: A retrospective case-control study was carried out to develop a predictive computational model to objectively and accurately represent the impact of laser vision correction (LVC) on the corneal structure. This study involved data from 3278 eyes (1690 patients) that remained stable after refractive surgery and 105 eyes (66 patients) that developed postoperative ectasia.
Methods: An artificial intelligence-based machine learning approach was used to create a predictive model for the impact of corneal refractive surgery. The development process was based on the practice of knowledge discovery in databases (KDD) and addressed each step, including data selection, preprocessing, data transformation, data mining, and model evaluation. To evaluate the predictive model output, we analyzed the receiver operating characteristic (ROC) curves to determine the area under the curve (AUC) and the optimal cutoff points, as well as sensitivity and specificity.
Results: The minimal pachymetry was superior to central (apex) pachymetry for all calculations. The Relational Tissue Altered (RTA) showed the highest AUC performance, with area under the curve (AUC) values of 0.913. These AUC values were significantly higher (according to the DeLong test) than those obtained with Residual Stromal Bed (RSB) values of 0.832 and 0.825 (apex), and Percent Tissue Altered (PTA) values of 0.805 (minimum (min)) and 0.800 (apex). RTA demonstrated a sensitivity of 76.0% (95% confidence interval (CI) 68.8-83.2%) and a specificity of 89.2% (95% CI 86.2-92.2%). PTA min showed a sensitivity of 66.0% (95% CI 58.0-74.0%) and a specificity of 85.4% (95% CI 82.0-88.8%).
Conclusions: The Relational Tissue Altered (RTA) index provides an objective and data-driven measure of the structural impact induced by laser vision correction (LVC) on the cornea. Compared with traditional parameters such as Residual Stromal Bed (RSB) and Percent Tissue Altered (PTA), which were not originally designed to quantify biomechanical disruption, RTA demonstrated superior performance in characterizing surgical impact. Although not developed as a standalone ectasia predictor, RTA offers unique value when integrated with preoperative assessments of intrinsic corneal susceptibility, including topometric, tomographic, and biomechanical metrics. This synergistic approach holds promise for enhancing risk stratification, refining surgical planning, and advancing the safety and personalization of refractive surgery.
期刊介绍：
Aims and Scope
Ophthalmology and Therapy is an international, open access, peer-reviewed (single-blind), and rapid publication journal. The scope of the journal is broad and will consider all scientifically sound research from preclinical, clinical (all phases), observational, real-world, and health outcomes research around the use of ophthalmological therapies, devices, and surgical techniques.
The journal is of interest to a broad audience of pharmaceutical and healthcare professionals and publishes original research, reviews, case reports/series, trial protocols and short communications such as commentaries and editorials. Ophthalmology and Therapy will consider all scientifically sound research be it positive, confirmatory or negative data. Submissions are welcomed whether they relate to an international and/or a country-specific audience, something that is crucially important when researchers are trying to target more specific patient populations. This inclusive approach allows the journal to assist in the dissemination of quality research, which may be considered of insufficient interest by other journals.
Rapid Publication
The journal’s publication timelines aim for a rapid peer review of 2 weeks. If an article is accepted it will be published 3–4 weeks from acceptance. The rapid timelines are achieved through the combination of a dedicated in-house editorial team, who manage article workflow, and an extensive Editorial and Advisory Board who assist with peer review. This allows the journal to support the rapid dissemination of research, whilst still providing robust peer review. Combined with the journal’s open access model this allows for the rapid, efficient communication of the latest research and reviews, fostering the advancement of ophthalmic therapies.
Open Access
All articles published by Ophthalmology and Therapy are open access.
Personal Service
The journal’s dedicated in-house editorial team offer a personal “concierge service” meaning authors will always have an editorial contact able to update them on the status of their manuscript. The editorial team check all manuscripts to ensure that articles conform to the most recent COPE, GPP and ICMJE publishing guidelines. This supports the publication of ethically sound and transparent research.
Digital Features and Plain Language Summaries
Ophthalmology and Therapy offers a range of additional features designed to increase the visibility, readership and educational value of the journal’s content. Each article is accompanied by key summary points, giving a time-efficient overview of the content to a wide readership. Articles may be accompanied by plain language summaries to assist readers who have some knowledge of, but not in-depth expertise in, the area to understand the scientific content and overall implications of the article. The journal also provides the option to include various types of digital features including animated abstracts, video abstracts, slide decks, audio slides, instructional videos, infographics, podcasts and animations. All additional features are peer reviewed to the same high standard as the article itself. If you consider that your paper would benefit from the inclusion of a digital feature, please let us know. Our editorial team are able to create high-quality slide decks and infographics in-house, and video abstracts through our partner Research Square, and would be happy to assist in any way we can. For further information about digital features, please contact the journal editor (see ‘Contact the Journal’ for email address), and see the ‘Guidelines for digital features and plain language summaries’ document under ‘Submission guidelines’.
For examples of digital features please visit our showcase page https://springerhealthcare.com/expertise/publishing-digital-features/
Publication Fees
Upon acceptance of an article, authors will be required to pay the mandatory Rapid Service Fee of €5250/$6000/£4300. The journal will consider fee discounts and waivers for developing countries and this is decided on a case by case basis.
Peer Review Process
Upon submission, manuscripts are assessed by the editorial team to ensure they fit within the aims and scope of the journal and are also checked for plagiarism. All suitable submissions are then subject to a comprehensive single-blind peer review. Reviewers are selected based on their relevant expertise and publication history in the subject area. The journal has an extensive pool of editorial and advisory board members who have been selected to assist with peer review based on the afore-mentioned criteria.
At least two extensive reviews are required to make the editorial decision, with the exception of some article types such as Commentaries, Editorials, and Letters which are generally reviewed by one member of the Editorial Board. Where reviewer recommendations are conflicted, the editorial board will be contacted for further advice and a presiding decision. Manuscripts are then either accepted, rejected or authors are required to make major or minor revisions (both reviewer comments and editorial comments may need to be addressed). Once a revised manuscript is re-submitted, it is assessed along with the responses to reviewer comments and if it has been adequately revised it will be accepted for publication. Accepted manuscripts are then copyedited and typeset by the production team before online publication. Appeals against decisions following peer review are considered on a case-by-case basis and should be sent to the journal editor.
Preprints
We encourage posting of preprints of primary research manuscripts on preprint servers, authors’ or institutional websites, and open communications between researchers whether on community preprint servers or preprint commenting platforms. Posting of preprints is not considered prior publication and will not jeopardize consideration in our journals. Authors should disclose details of preprint posting during the submission process or at any other point during consideration in one of our journals. Once the manuscript is published, it is the author’s responsibility to ensure that the preprint record is updated with a publication reference, including the DOI and a URL link to the published version of the article on the journal website.
Please follow the link for further information on preprint sharing:
https://www.springer.com/gp/authors-editors/journal-author/journal-author-helpdesk/submission/1302#c16721550
Copyright
Ophthalmology and Therapy''s content is published open access under the Creative Commons Attribution-Noncommercial License, which allows users to read, copy, distribute, and make derivative works for non-commercial purposes from the material, as long as the author of the original work is cited. The author assigns the exclusive right to any commercial use of the article to Springer. For more information about the Creative Commons Attribution-Noncommercial License, click here: http://creativecommons.org/licenses/by-nc/4.0.
Contact
For more information about the journal, including pre-submission enquiries, please contact christopher.vautrinot@springer.com.
求助内容：
应助结果提醒方式：
京公网安备 11010802042870号
