Mehravaran Shiva, Eghrari Allen, Yousefi Siamak, Khalifa Fahmi, Ghiasi Guita, Farahi Azadeh
Department of Biology, School of Computer, Mathematical, and Natural Sciences, Morgan State University, Baltimore, MD 21251, USA.
Department of Ophthalmology, Johns Hopkins University School of Medicine, Baltimore, MD 21287, USA.
Int J Environ Res Public Health. 2025 May 9;22(5):747. doi: 10.3390/ijerph22050747.
This study aimed to evaluate the effectiveness of an innovative platform (the Bilateral Corneal Symmetry 3-D Analyzer-BiCSA) and a novel corneal symmetry index (the Volume Between Spheres-VBS) in differentiating normal corneas from those with keratoconus. Pentacam imaging data from 30 healthy corneas and 30 keratoconus cases were analyzed. BiCSA was utilized to determine the VBS for each case. Statistical analyses included comparing mean VBS values between groups and assessing sensitivity, specificity, and positive predictive values (PPVs). Keratoconus patients exhibited significantly higher VBS scores compared to healthy controls, particularly within the central 4.0 mm zone (11.4 versus 6.3). Using a VBS threshold of 11.3 in the central zone identified 40% of keratoconus cases (40% sensitivity), but 100% of cases surpassing the threshold were keratoconus (100% PPV). Lowering the threshold to 10.4 increased case detection to 90% while maintaining a high PPV (84.2%). These findings suggest that VBS, particularly when focused on the central 4.0 mm zone, can be a valuable tool for early keratoconus screening and identifying potential corneal abnormalities requiring further clinical evaluation. No healthy control corneas in this study exceeded a VBS threshold of 11.4 at 4 mm, indicating that values above this warrant further investigation.
本研究旨在评估一种创新平台（双侧角膜对称性三维分析仪-BiCSA）和一种新型角膜对称性指数（球间体积-VBS）在区分正常角膜与圆锥角膜方面的有效性。分析了30例健康角膜和30例圆锥角膜病例的Pentacam成像数据。利用BiCSA确定每个病例的VBS。统计分析包括比较组间平均VBS值以及评估敏感性、特异性和阳性预测值（PPV）。与健康对照组相比，圆锥角膜患者的VBS评分显著更高，尤其是在中央4.0毫米区域内（11.4对6.3）。在中央区域使用11.3的VBS阈值可识别出40%的圆锥角膜病例（敏感性40%），但超过该阈值的病例100%为圆锥角膜（PPV 100%）。将阈值降低至10.4可将病例检出率提高至90%，同时保持较高的PPV（84.2%）。这些发现表明，VBS，尤其是聚焦于中央4.0毫米区域时，可成为圆锥角膜早期筛查以及识别需要进一步临床评估的潜在角膜异常的有价值工具。本研究中没有健康对照角膜在4毫米处超过11.4的VBS阈值，这表明高于该值的情况需要进一步调查。
