Optimized Artificial Intelligence for Enhanced Ectasia Detection Using Scheimpflug-Based Corneal Tomography and Biomechanical Data

Ambrósio, Renato; Machado, Aydano Pamponet; Leão, Edileuza Virginio; Lyra, João Marcelo; Salomão, Marcella Q.; Esporcatte, Louise G Pellegrino; Filho, João B R da Fonseca; Ferreira-Meneses, Erica; Sena, Nelson; Haddad, Jorge Selem; Neto, Alexandre Costa; Almeida, Gildasio Castelo de; Roberts, Cynthia J.; Elsheikh, Ahmed; Vinciguerra, Riccardo; Vinciguerra, Paolo; Bühren, Jens; Kohnen, Thomas; Kezirian, Guy M.; Hafezi, Farhad; Hafezi, Farhad; Torres-Netto, Emílio A.; Lu, Nan‐Ji; Kang, Dukjin; Kermani, Omid; Koh, Shizuka; Padmanabhan, Prema; Taneri, Suphi; Trattler, William; Gualdi, Luca; Salgado-Borges, José; Faria-Correia, Fernando; Flockerzi, Elias; Seitz, Berthold; Jhanji, Vishal; Chan, Tommy C Y; Baptista, Pedro Manuel; Reinstein, Dan Z.; Archer, Timothy J; Rocha, Karolinne Maia; Waring, George O.; Krueger, Ronald R.; Dupps, William J.; Khoramnia, Ramin; Hashemi, Hassan; Asgari, Soheila; Momeni‐Moghaddam, Hamed; Zarei‐Ghanavati, Siamak; Shetty, Rohit; Khamar, Pooja; Belin, Michael W.; Lopes, Bernardo

doi:10.1016/j.ajo.2022.12.016

Cited by 43 publications

(21 citation statements)

References 114 publications

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“…In the case of a false positive result, patients with healthy eyes may be excluded from receiving a refractive operation, even though there is no risk of developing ectasia in this case. Better accuracy with the TBI can potentially be achieved through the use of artificial intelligence, such as with TBIv2, for example [47].…”

Section: Discussionmentioning

confidence: 99%

Biomechanische Analyse von tomografisch unauffälligen Keratokonus-Partneraugen mit dem Corvis ST

Augustin,

Son,

Kovalchuk

et al. 2023

Klin Monbl Augenheilkd

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Zusammenfassung Hintergrund Der Keratokonus ist eine bilaterale, asymmetrische Erkrankung. In seltenen Fällen zeigen Keratokonus-Patienten keinerlei tomografische Auffälligkeiten am Partnerauge. Das Ziel der Studie war die Analyse der Biomechanik von tomografisch regelrechten Partneraugen bei Patienten mit stark asymmetrischer Ektasie. Material und Methoden In dieser retrospektiven, konsekutiven Fallserie wurden 916 Augen von 458 Keratokonus-Patienten untersucht, die sich im Zeitraum von 2 Jahren in unserer Keratokonus-Sprechstunde vorstellten. Insgesamt zeigten hiervon 34 Patienten (7,4%) keine klinischen oder tomografischen Zeichen für einen Keratokonus am Partnerauge. Die Untersuchungsparameter dieser Patienten waren der bestkorrigierte Fernvisus (BCVA, Best-corrected Visual Acuity), die tomografische Analyse mittels Scheimpflug-Bildgebung (Pentacam AXL, Oculus, Wetzlar, Deutschland) und die biomechanische Analyse mittels Corvis ST (Oculus, Wetzlar, Deutschland). Mittels Tomografie wurden die anteriore und die posteriore Hornhautkurvatur, der K-Max, die dünnste Hornhautdicke (TCT), das Belin/Ambrosio Deviation Display (BAD-D) sowie das ABCD-Grading untersucht. Die Biomechanik wurde mit dem Corvis Biomechanischen Index (CBI) und dem Tomografischen Biomechanischen Index (TBI) analysiert. Ergebnisse Der mittlere BCVA war − 0,02 ± 0,13 logMAR. Der mittlere K-Max betrug 43,87 ± 1,21 dpt, die mittlere TCT 532 ± 23 µm, und der mittlere BAD-D 1,02 ± 0,43. Der mittlere CBI war 0,28 ± 0,26. Regelrechte CBI-Werte zeigten sich in 47%. Der mittlere TBI lag bei 0,34 ± 0,30. Nur 13 Patienten zeigten einen unauffälligen TBI (38%) und bei nur 7 Patienten (21%) waren sowohl CBI als auch TBI regelrecht. Der CBI zeigte eine Sensitivität von 53% und der TBI eine Sensitivität von 62%, den Keratokonus in einem tomografisch unauffälligen Keratokonus-Partnerauge zu detektieren. Schlussfolgerung Selten zeigt sich bei Keratokonus-Patienten ein sehr asymmetrischer Befund, mit klinisch und tomografisch regelrechtem Partnerauge. In diesem Fall lohnt sich eine biomechanische Analyse, um den Keratokonus auf diesem Wege zu erkennen und zu kontrollieren. Der TBI war hierbei am sensitivsten, um erste Auffälligkeiten nachzuweisen.

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Section: Discussionmentioning

confidence: 99%

Biomechanische Analyse von tomografisch unauffälligen Keratokonus-Partneraugen mit dem Corvis ST

Augustin,

Son,

Kovalchuk

et al. 2023

Klin Monbl Augenheilkd

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“…First, the comparability of studies on the keratoconus prevalence markedly depends on the definition of keratoconus. 3,37–39 Although studies based on health registries have to apply the definition(s) of the disease as used by the health practitioners in the region, population-based studies can use definitions based on the corneal parameters they measure. These differences may explain the discrepancies between the relatively low prevalence of keratoconus in investigations using databases of health registries and studies directly examining their participants 25 .…”

Section: Discussionmentioning

confidence: 99%

Prevalence and Associations of Keratoconus Among Children, Adults, and Elderly in the Population-Based Ural Eye Studies

Bikbov,

Kazakbaeva,

Gilmanshin

et al. 2023

Asia-Pacific Journal of Ophthalmology

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Purpose: To estimate prevalence and associations of keratoconus in populations in Russia with an age from childhood to seniority. Methods: The study population consisted of the cohorts of 3 population-based studies performed in urban and rural areas within the same geographical region in Bashkortostan/Russia: the Ural Children Eye Study (UCES; age = 6–18 y; n = 4890), the Ural Eye and Medical Study (UEMS; age = >40 y; n = 5314), and the Ural Very Old Study (UVOS; age = >85 y; n = 651). Based on Scheimflug imaging, keratoconus was defined by a keratometric reading of ≥48 diopters (D) in any eye. Results: The mean maximal and minimal corneal refractive power increased from the UCES (43.58 ± 1.50 D and 42.70 ± 1.42 D, respectively) to the UEMS (44.26 ± 1.70 D and 43.61 ± 1.76 D, respectively) and to the UVOS (45.1 ± 1.72 D and 43.98 ± 1.68 D, respectively). Correspondingly, keratoconus prevalence increased from the UCES (42/4890; 0.086%; 95% CI = 0.060, 0.112) to the UEMS (112/5314; 2.11%; 95% CI = 1.72, 2.49) and to the UVOS (42/651; 6.45%; 95% CI = 4.56, 8.34). In the UCES, higher keratoconus prevalence was associated (multivariable analysis) with higher birth order [odds ratio (OR) = 2.34; 95% CI = 1.32, 4.15; P = 0.004], lower birth weight (OR = 0.99; 95% CI = 0.99, 0.99; P < 0.001), and shorter axial length (OR = 0.15; 95% CI = 0.08, 0.30; P < 0.001). In the UEMS, keratoconus prevalence correlated with shorter axial length (OR = 0.15; 95% CI = 0.10, 0.23; P < 0.001), larger corneal volume (OR = 1.17; 95% CI = 1.09, 1.25; P = 0.001), thicker lens (OR = 2.27; 95% CI = 1.06, 5.28; P = 0.04), cortical cataract degree (OR = 1.02; 95% CI = 1.01, 1.04; P = 0.01), and higher stage of age-related macular degeneration (OR = 1.65; 95% CI = 1.09, 2.51; P = 0.02). In the UVOS, keratoconus prevalence correlated with lower educational level (OR = 0.84; 95% CI = 0.71, 0.99; P = 0.04) and lower dynamometric handgrip force (OR = 0.92; 95% CI = 0.88, 0.97; P = 0.003). Conclusions: In this study on multiethnic groups from Russia, keratoconus prevalence increased from the pediatric group (0.09%) to the adult group (2.11%) and seniority group (6.45%), correlated mostly with biometric ocular parameters and was in all age groups statistically independent of most systemic parameters.

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“…In addition, we also evaluate corneal biomechanical properties and epithelial thickness maps routinely to determine candidacy for corneal refractive surgery. 1,2…”

Section: H Burkhard Dick MD Phd Febos-cr Suphi Taneri Md Febos-crmentioning

confidence: 99%

“…4 We recommend completing the assessment with Scheimpflug biomechanical testing for calculating the tomographic-biomechanical index. 5 In addition, epithelial thickness mapping would be of interest. 1…”

Section: Aydano P Machado MD Phd João Marcelo Lyra Md Phdmentioning

confidence: 99%

Decision taking in corneal refractive surgery

Nuijts

Cummings

Dick

et al. 2023

J Cataract Refract Surg

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Optimized Artificial Intelligence for Enhanced Ectasia Detection Using Scheimpflug-Based Corneal Tomography and Biomechanical Data

Cited by 43 publications

References 114 publications

Biomechanische Analyse von tomografisch unauffälligen Keratokonus-Partneraugen mit dem Corvis ST

Biomechanische Analyse von tomografisch unauffälligen Keratokonus-Partneraugen mit dem Corvis ST

Prevalence and Associations of Keratoconus Among Children, Adults, and Elderly in the Population-Based Ural Eye Studies

Decision taking in corneal refractive surgery

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