Corneal and External Diseases Department, Singapore National Eye Centre, Singapore 169856, Singapore.
Tissue Engineering and Cell Therapy Group, Singapore Eye Research Institute, Singapore 169856, Singapore.
Cells. 2023 Apr 15;12(8):1167. doi: 10.3390/cells12081167.
(1) Background: Cell injection therapy is an emerging treatment for bullous keratopathy (BK). Anterior segment optical coherence tomography (AS-OCT) imaging allows the high-resolution assessment of the anterior chamber. Our study aimed to investigate the predictive value of the visibility of cellular aggregates for corneal deturgescence in an animal model of bullous keratopathy. (2) Methods: Cell injections of corneal endothelial cells were performed in 45 eyes in a rabbit model of BK. AS-OCT imaging and central corneal thickness (CCT) measurement were performed at baseline and on day 1, day 4, day 7 and day 14 following cell injection. A logistic regression was modelled to predict successful corneal deturgescence and its failure with cell aggregate visibility and CCT. Receiver-operating characteristic (ROC) curves were plotted, and areas under the curve (AUC) calculated for each time point in these models. (3) Results: Cellular aggregates were identified on days 1, 4, 7 and 14 in 86.7%, 39.5%, 20.0% and 4.4% of eyes, respectively. The positive predictive value of cellular aggregate visibility for successful corneal deturgescence was 71.8%, 64.7%, 66.7% and 100.0% at each time point, respectively. Using logistic regression modelling, the visibility of cellular aggregates on day 1 appeared to increase the likelihood of successful corneal deturgescence, but this did not reach statistical significance. An increase in pachymetry, however, resulted in a small but statistically significant decreased likelihood of success, with an odds ratio of 0.996 for days 1 (95% CI 0.993-1.000), 2 (95% CI 0.993-0.999) and 14 (95% CI 0.994-0.998) and an odds ratio of 0.994 (95% CI 0.991-0.998) for day 7. The ROC curves were plotted, and the AUC values were 0.72 (95% CI 0.55-0.89), 0.80 (95% CI 0. 62-0.98), 0.86 (95% CI 0.71-1.00) and 0.90 (95% CI 0.80-0.99) for days 1, 4, 7 and 14, respectively. (4) Conclusions: Logistic regression modelling of cell aggregate visibility and CCT was predictive of successful corneal endothelial cell injection therapy.
(1) 背景：细胞注射疗法是治疗大疱性角膜病变（BK）的一种新兴治疗方法。眼前节光学相干断层扫描（AS-OCT）成像可实现眼前节的高分辨率评估。我们的研究旨在探讨在兔 BK 模型中，细胞聚集体的可见性对角膜脱水的预测价值。（2）方法：在兔 BK 模型中对 45 只眼睛进行角膜内皮细胞注射。在细胞注射后第 1、4、7 和 14 天进行 AS-OCT 成像和中央角膜厚度（CCT）测量。使用逻辑回归模型预测细胞聚集体可见性与 CCT 对成功角膜脱水及其失败的预测价值。绘制受试者工作特征（ROC）曲线，并计算每个时间点的曲线下面积（AUC）。（3）结果：在第 1、4、7 和 14 天，分别有 86.7%、39.5%、20.0%和 4.4%的眼睛中可识别出细胞聚集体。在每个时间点，细胞聚集体可见性对成功角膜脱水的阳性预测值分别为 71.8%、64.7%、66.7%和 100.0%。使用逻辑回归模型，第 1 天细胞聚集体的可见性似乎增加了成功角膜脱水的可能性，但未达到统计学意义。然而，角膜厚度的增加导致成功可能性略有但具有统计学意义的降低，第 1 天（95%CI 0.993-1.000）、第 2 天（95%CI 0.993-0.999）和第 14 天（95%CI 0.994-0.998）的比值比为 0.996，第 7 天（95%CI 0.991-0.998）的比值比为 0.994。绘制 ROC 曲线，AUC 值分别为 0.72（95%CI 0.55-0.89）、0.80（95%CI 0.62-0.98）、0.86（95%CI 0.71-1.00）和 0.90（95%CI 0.80-0.99）。（4）结论：细胞聚集体可见性和 CCT 的逻辑回归模型可预测角膜内皮细胞注射治疗的成功。
