Esaka Yuri, Kojima Takashi, Dogru Murat, Hasegawa Asato, Tamaoki Akeno, Uno Yunako, Nishida Tomoya, Nakamura Tomoaki, Hara Syuya, Ichikawa Kazuo
Department of Ophthalmology, Japan Community Health Care Organization Chukyo Hospital, Nagoya, Japan.
Department of Ophthalmology, Keio University School of Medicine, Tokyo, Japan.
Cornea. 2019 Sep;38(9):1154-1160. doi: 10.1097/ICO.0000000000002043.
This study aimed to predict the best-corrected visual acuity (BCVA) based on swept-source optical coherence tomography (SS-OCT) parameters in eyes with keratoconus.
We retrospectively reviewed 135 eyes of 135 patients with keratoconus (mean age: 31.9 ± 12.4 years). The average keratometry value and BCVA (logarithm of the minimal angle of resolution [Snellen]) were 48.68 ± 5.44 diopter and 0.20 ± 0.36 (20/25), respectively. Eleven parameters were calculated using SS-OCT. Apart from the corneal height and elevation, all the other parameters were calculated from both anterior and posterior corneal OCT data. The patients were divided into 2 groups, 1 for creating the prediction equation (prediction group, 86 eyes) and another for verifying the equation (verification group, 49 eyes). In the former, individual correlations between the BCVA and SS-OCT parameters were analyzed. A stepwise multiple regression analysis was performed with the BCVA as a dependent variable and SS-OCT parameters as independent variables. After its creation, the accuracy of the prediction equation was verified in the verification group.
All the parameters, except for age and total corneal cylinder, showed statistically significant correlations with BCVA (P < 0.0001). Using the stepwise multiple regression analysis, we selected 2 explanatory variables: root mean square of anterior corneal elevation (standardized regression coefficient: 1.221; P < 0.0001) and total coma aberration (standardized regression coefficient: -0.575; P = 0.001; adjusted R = 0.546). The prediction was correct in 84.6% of the eyes within ±1 line of Snellen BCVA.
Using the equation we derived from SS-OCT parameters is a promising method to predict visual function in patients with keratoconus.
本研究旨在基于扫频光学相干断层扫描(SS-OCT)参数预测圆锥角膜患者的最佳矫正视力(BCVA)。
我们回顾性分析了135例圆锥角膜患者的135只眼(平均年龄:31.9±12.4岁)。平均角膜曲率值和BCVA(最小分辨角对数[Snellen])分别为48.68±5.44屈光度和0.20±0.36(20/25)。使用SS-OCT计算了11个参数。除角膜高度和隆起外,所有其他参数均根据角膜前、后OCT数据计算得出。患者分为两组,一组用于创建预测方程(预测组,86只眼),另一组用于验证方程(验证组,49只眼)。在前者中,分析了BCVA与SS-OCT参数之间的个体相关性。以BCVA为因变量,SS-OCT参数为自变量进行逐步多元回归分析。创建方程后,在验证组中验证预测方程的准确性。
除年龄和角膜总柱镜度数外,所有参数与BCVA均有统计学显著相关性(P<0.0001)。通过逐步多元回归分析,我们选择了2个解释变量:角膜前表面隆起均方根(标准化回归系数:1.221;P<0.0001)和总彗差(标准化回归系数:-0.575;P=0.001;调整后R=0.546)。在Snellen BCVA±1行范围内,84.6%的眼睛预测正确。
使用我们从SS-OCT参数推导的方程是预测圆锥角膜患者视觉功能的一种有前景的方法。