Automatic Quantitative Assessment of Lens Opacities Using Two Anterior Segment Imaging Techniques: Correlation with Functional and Surgical Metrics

Abstract

The purpose of this study is to quantitatively assess lens opacity, using a swept-source optical coherence tomography (SS-OCT) device for anterior segment assessment, and establish the correlation with Scheimpflug imaging, corrected distance visual acuity (CDVA) and cumulative dissipated energy (CDE). This prospective cross-sectional single-center study enrolled 51 patients (51 eyes) with crystalline lens opacity. Patients with previous ocular surgery, pathologies or general disorders affecting vision were excluded. Eyes were scanned with an SS-OCT device, and lens densitometry was automatically analyzed using a custom MATLAB script which examined lens density, nuclear density and linear density. The same analyses were performed on Scheimpflug images. Preoperative CDVA and CDE during phacoemulsification were recorded. Spearman’s (ρ) and Pearson’s (r) correlation coefficients were assessed according to data normality. Statistically significant correlations were established between SS-OCT and Scheimpflug imaging using lens analysis (ρ = 0.47, p < 0.001), nuclear analysis (ρ = 0.73, p < 0.001) and linear analysis (r = 0.44, p < 0.001). A significant correlation with CDE was found with all the SS-OCT methods (r = 0.57, p < 0.001). Only the nuclear analysis of the SS-OCT scans (Tb = −0.33, p < 0.01) and Pentacam Nucleus Staging (Tb = −0.26, p < 0.05) showed a statistically significant correlation with CDVA. Good inter-device agreement in lens densitometry was found. However, SS-OCT yielded improved lens imaging compared with the Scheimpflug device and a higher correlation with clinical parameters. Thus, high-resolution SS-OCT has the potential to become a preferable option for automatic cataract grading and preoperative planning.

Cataract Classification Systems: A Review

“…The increased resolution and clear posterior lens edge also open the possibility for computer-based automatic lens structure segmentation, eliminating user bias. These automatic methods have shown both excellent repeatability and robustness [31,32]. Additionally, when compared to Scheimpflug imaging, AS-OCT outperforms it when correlated to visual acuity and phacoemulsification energy, demonstrating the utility of the features discussed above [29,32].…”

“…These automatic methods have shown both excellent repeatability and robustness [31,32]. Additionally, when compared to Scheimpflug imaging, AS-OCT outperforms it when correlated to visual acuity and phacoemulsification energy, demonstrating the utility of the features discussed above [29,32]. AS-OCT also shows a good correlation to the LOCS III system, particularly to the NO [33 -35].…”

Change in Subfoveal Choroidal Thickness following Cataract Surgery Imaged with Enhanced Depth Imaging Optical Coherence Tomography

“…Additionally, the ANTERION (Heidelberg Engineering GmbH, Heidelberg, Germany), a swept-source OCT (SS-OCT) device, was used to obtain high-resolution cross-sections of the anterior segment. Using a custom MATLAB script (Version R2021b, MathWorks, Natick, MA, USA), the lens and the nucleus were automatically segmented, and their respective density calculated [11].…”

Impact of Phacoemulsification Parameters on Central Retinal Thickness Change Following Cataract Surgery

“…To account for the background noise, the script subtracted the value of the anterior chamber density. This method has been validated in a previous study [11].…”