Department of Ophthalmology, Jiangxi Provincial Hospital of Integrated Chinese and Western Medicine, the Fourth Affiliated Hospital of Jiangxi University of Traditional Chinese Medicine, Nanchang, 330003, China.
Nanchang Aier Eye Hospital, Nanchang, 330006, China.
BMC Ophthalmol. 2024 May 6;24(1):206. doi: 10.1186/s12886-024-03431-8.
The main objective is to quantify the lens nuclear opacity using spectral-domain optical coherence tomography (SD-OCT) and to evaluate its association with Lens Opacities Classification System III (LOCS-III) system, lens thickness (LT), and surgical parameters. The secondary objective is to assess the diagnostic model performance for hard nuclear cataract.
This study included 70 eyes of 57 adults with cataract, with 49 (70%) and 21 (30%) in training and validation cohort, respectively. Correlations of the average nuclear density (AND) /maximum nuclear density (MND) with LOCS-III scores, LT, and surgical parameters were analyzed. Univariate and multivariate logistic regression analysis, receiver operating characteristic curves and calibration curves were performed for the diagnostic of hard nuclear cataract.
The pre-operative uncorrected distance visual acuity (UDVA), intraocular pressure (IOP), mean axial length (AL), and LT were 1.20 ± 0.47 log MAR, 15.50 ± 2.87 mmHg, 27.34 ± 3.77 mm and 4.32 ± 0.45 mm, respectively. The average nuclear opalescence (NO) and nuclear colour (NC) scores were 3.61 ± 0.94 and 3.50 ± 0.91 (ranging from 1.00 to 6.90), respectively. The average AND and MND were 137.94 ± 17.01 and 230.01 ± 8.91, respectively. NC and NO scores both significantly correlated with the AND (rNC = 0.733, p = 0.000; rNO = 0.755, p = 0.000) and MND (rNC = 0.643, p = 0.000; rNO = 0.634, p = 0.000). In the training cohort, the area under the curve (AUC) of the model was 0.769 (P < 0.001, 95%CI 0.620-0.919), which had a good degree of differentiation (Fig. 2a). The calibration curve showed good agreement between predicted and actual probability.
The nuclear density measurement on SD-OCT images can serve as an objective and reliable indicator for quantifying nuclear density.
本研究旨在使用谱域光相干断层扫描（SD-OCT）定量评估晶状体核混浊，并评估其与晶状体混浊分类系统 III （LOCS-III）、晶状体厚度（LT）和手术参数的相关性。次要目的是评估核性白内障的诊断模型性能。
本研究纳入了 70 只白内障成年患者的 70 只眼，其中 49 只眼（70%）和 21 只眼（30%）分别纳入训练队列和验证队列。分析平均核密度（AND）/最大核密度（MND）与 LOCS-III 评分、LT 和手术参数的相关性。进行单变量和多变量逻辑回归分析、受试者工作特征曲线和校准曲线，以诊断核性白内障。
术前未矫正远视力（UDVA）、眼内压（IOP）、平均眼轴（AL）和 LT 分别为 1.20±0.47 log MAR、15.50±2.87 mmHg、27.34±3.77 mm 和 4.32±0.45 mm。平均核混浊（NO）和核色（NC）评分分别为 3.61±0.94 和 3.50±0.91（范围为 1.00-6.90）。平均 AND 和 MND 分别为 137.94±17.01 和 230.01±8.91。NC 和 NO 评分均与 AND（rNC=0.733，p=0.000；rNO=0.755，p=0.000）和 MND（rNC=0.643，p=0.000；rNO=0.634，p=0.000）显著相关。在训练队列中，模型的曲线下面积（AUC）为 0.769（P<0.001，95%CI 0.620-0.919），具有较好的区分度（图 2a）。校准曲线显示预测概率与实际概率吻合良好。
SD-OCT 图像上的核密度测量可作为定量评估核密度的客观可靠指标。
