The application of corneal biomechanical interocular asymmetry for the diagnosis of keratoconus and subclinical keratoconus

Frontiers in Bioengineering and Biotechnology

Bioengineering and Biotechnology

Yueguo Chen¹  Yan Liu¹  Ruilan Dong¹  Yu Zhang¹ 

[1] Department of Ophthalmology, Peking University Third Hospital, Beijing, China;Beijing Key Laboratory of Restoration of Damaged Ocular Nerve, Peking University Third Hospital, Beijing, China;Peking University Institute of Laser Medicine, Beijing, China;

关键词: corneal biomechanics;    interocular asymmetry;    keratoconus;    subclinical keratoconus;    diagnostic model;    artificial intelligence;   

DOI  :  10.3389/fbioe.2023.1266940

 received in 2023-07-25, accepted in 2023-09-20,  发布年份 2023

来源: Frontiers

【 摘 要 】

Purpose: To evaluate the interocular consistency of biomechanical properties in normal, keratoconus (KC) and subclinical keratoconus (SKC) populations and explore the application of interocular asymmetry values in KC and SKC diagnoses.Methods: This was a retrospective chart-review study of 331 ametropic subjects (control group) and 207 KC patients (KC group, including 94 SKC patients). Interocular consistency was evaluated using the intraclass correlation coefficient (ICC). Interocular asymmetry was compared between the control and KC groups and its correlation with disease severity was analyzed. Three logistic models were constructed using biomechanical monocular parameters and interocular asymmetry values. The diagnostic ability of interocular asymmetry values and the newly established models were evaluated using receiver operating characteristic curves and calibration curves. Net reclassification improvement (NRI) and integrated discrimination improvement (IDI) were also estimated.Results: The interocular consistency significantly decreased and the interocular asymmetry values increased in KC patients compared with those in control individuals. In addition, the interocular asymmetry values increased with respect to the severity of KC. The binocular assisted biomechanical index (BaBI) had an area under the curve (AUC) of 0.998 (97.8% sensitivity, 99.2% specificity; cutoff 0.401), which was statistically higher than that of the Corvis biomechanical index [CBI; AUC = 0.935, p < 0.001 (DeLong’s test), 85.6% sensitivity]. The optimized cutoff of 0.163 provided an AUC of 0.996 for SKC with 97.8% sensitivity, which was higher than that of CBI [AUC = 0.925, p < 0.001 (DeLong’s test), 82.8% sensitivity].Conclusion: Biomechanical interocular asymmetry values can reduce the false-negative rate and improve the performance in KC and SKC diagnoses.

【 授权许可】

Unknown   
Copyright © 2023 Dong, Liu, Zhang and Chen.