Influence of Keratoconus Severity on Detecting True Progression with Scheimpflug Imaging and Anterior Segment Optical Coherence Tomography
Abstract
:1. Introduction
2. Materials and Methods
2.1. Patients
2.2. Devices
2.3. Measurement Procedure
2.4. Statistical Analysis
3. Results
3.1. Patient Demographics
3.2. Intrasession Repeatability
3.3. Intersession Reproducibility
3.4. Cut-off Values to Consider a Corneal Shape Change
4. Discussion
5. Conclusions
Supplementary Materials
Author Contributions
Funding
Institutional Review Board Statement
Informed Consent Statement
Data Availability Statement
Conflicts of Interest
References
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Parameter | Group | Mean ± SD | Sw | r | CV (%) | 95% LOA | ICC | p-Value |
---|---|---|---|---|---|---|---|---|
PENTACAM | ||||||||
K1 (D) | Control | 43.29 ± 1.11 | 0.06 | 0.16 | 0.15 | −0.29 to 0.27 | 0.99 | 0.76 |
Mild | 44.09 ± 1.90 | 0.10 | 0.28 | 0.23 | −0.40 to 0.37 | 0.99 | 0.82 | |
Moderate | 44.60 ± 2.98 | 0.13 | 0.36 | 0.30 | −0.48 to 0.42 | 0.99 | 0.49 | |
Severe | 47.27 ± 4.20 | 0.24 | 0.66 | 0.52 | −0.86 to 0.85 | 0.99 | 0.96 | |
K2 (D) | Control | 44.09 ± 0.94 | 0.08 | 0.23 | 0.18 | −0.32 to 0.36 | 0.99 | 0.61 |
Mild | 46.47 ± 2.03 | 0.12 | 0.33 | 0.26 | −0.48 to 0.46 | 0.99 | 0.92 | |
Moderate | 48.48 ± 2.47 | 0.14 | 0.39 | 0.29 | −0.53 to 0.50 | 0.99 | 0.73 | |
Severe | 51.41 ± 4.70 | 0.23 | 0.63 | 0.44 | −1.07 to 0.75 | 0.99 | 0.14 | |
Kmax-A (D) | Control | 44.47 ± 1.15 | 0.10 | 0.28 | 0.18 | −0.43 to 0.41 | 0.99 | 0.83 |
Mild | 49.03 ± 2.15 | 0.23 | 0.63 | 0.46 | −0.95 to 0.79 | 0.98 | 0.48 | |
Moderate | 53.64 ± 2.72 | 0.25 | 0.70 | 0.47 | −1.09 to 0.80 | 0.98 | 0.18 | |
Severe | 59.71 ± 5.73 | 0.29 | 0.81 | 0.49 | −1.11 to 1.02 | 0.98 | 0.72 | |
Kmax-P (D) | Control | −7.02 ± 0.83 | 0.03 | 0.08 | 0.39 | −0.11 to 0.08 | 0.99 | 0.66 |
Mild | −7.59 ± 0.54 | 0.07 | 0.20 | 0.88 | −0.25 to 0.16 | 0.98 | 0.37 | |
Moderate | −8.57 ± 0.65 | 0.11 | 0.30 | 1.36 | −0.50 to 0.35 | 0.96 | 0.12 | |
Severe | −9.76 ± 0.95 | 0.15 | 0.41 | 1.41 | −0.54 to 0.58 | 0.96 | 0.64 | |
TCT (µm) | Control | 560.42 ± 31.78 | 2.90 | 8.02 | 0.52 | −9.58 to 9.58 | 0.99 | 0.86 |
Mild | 495.00 ± 35.80 | 2.92 | 8.09 | 0.60 | −10.82 to 9.82 | 0.99 | 0.71 | |
Moderate | 480.33 ± 44.97 | 4.48 | 12.40 | 0.96 | −15.87 to 15.70 | 0.99 | 0.96 | |
Severe | 456.17 ± 34.47 | 5.11 | 14.15 | 1.13 | −15.56 to 18.67 | 0.98 | 0.50 | |
CASIA SS-1000 | ||||||||
K1 (D) | Control | 43.16 ± 0.83 | 0.04 | 0.11 | 0.08 | −0.16 to 0.11 | 0.99 | 0.98 |
Mild | 44.05 ± 1.90 | 0.06 | 0.16 | 0.14 | −0.24 to 0.12 | 0.99 | 0.65 | |
Moderate | 44.52 ± 2.70 | 0.12 | 0.33 | 0.27 | −0.44 to 0.42 | 0.99 | 0.71 | |
Severe | 46.24 ± 3.07 | 0.16 | 0.44 | 0.34 | −0.61 to 0.72 | 0.99 | 0.32 | |
K2 (D) | Control | 43.71 ± 1.03 | 0.05 | 0.14 | 0.10 | −0.20 to 0.11 | 0.99 | 0.75 |
Mild | 45.54 ± 2.04 | 0.05 | 0.15 | 0.11 | −0.18 to 0.14 | 0.99 | 0.63 | |
Moderate | 47.07 ± 2.21 | 0.12 | 0.33 | 0.25 | −0.36 to 0.49 | 0.99 | 0.16 | |
Severe | 49.46 ± 3.30 | 0.13 | 0.36 | 0.26 | −0.36 to 0.50 | 0.99 | 0.11 | |
Kmax-A (D) | Control | 44.31 ± 0.89 | 0.08 | 0.22 | 0.18 | −0.33 to 0.23 | 0.99 | 0.19 |
Mild | 47.83 ± 1.96 | 0.17 | 0.47 | 0.35 | −0.65 to 0.56 | 0.99 | 0.44 | |
Moderate | 51.62 ± 2.37 | 0.18 | 0.50 | 0.35 | −0.47 to 0.76 | 0.99 | 0.14 | |
Severe | 56.15 ± 4.39 | 0.23 | 0.63 | 0.39 | −0.86 to 0.81 | 0.99 | 0.84 | |
Kmax-P (D) | Control | −6.39 ± 0.16 | 0.01 | 0.02 | 0.13 | −0.07 to 0.07 | 0.99 | 0.71 |
Mild | −7.41 ± 0.56 | 0.02 | 0.05 | 0.24 | −0.11 to 0.11 | 0.99 | 0.54 | |
Moderate | −8.14 ± 0.54 | 0.03 | 0.08 | 0.34 | −0.15 to 0.11 | 0.99 | 0.14 | |
Severe | −9.06 ± 0.85 | 0.05 | 0.13 | 0.56 | −0.24 to 0.23 | 0.99 | 0.85 | |
TCT (µm) | Control | 538.24 ± 28.66 | 0.75 | 2.07 | 0.13 | −3.21 to 2.97 | 0.99 | 0.31 |
Mild | 482.50 ± 32.64 | 0.81 | 2.24 | 0.17 | −3.32 to 3.63 | 0.99 | 0.19 | |
Moderate | 466.88 ± 40.63 | 1.06 | 2.93 | 0.23 | −3.79 to 4.79 | 0.99 | 0.27 | |
Severe | 438.55 ± 32.62 | 1.08 | 2.99 | 0.26 | −5.40 to 5.08 | 0.99 | 0.63 |
Reproducibility (Method 1) | Reproducibility (Method 2) | ||||||||||||||
---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
Parameter | Group | SD of Diff | SR | R | CV (%) | 95% LOA | ICC | p-Value | SD of Diff | SR | R | CV (%) | 95% LOA | ICC | p-Value |
PENTACAM | |||||||||||||||
K1 (D) | Control | 0.16 | 0.10 | 0.27 | 0.23 | −0.24 to 0.40 | 0.99 | 0.45 | 0.16 | 0.08 | 0.22 | 0.19 | −0.26 to 0.35 | 0.99 | 0.90 |
Mild | 0.26 | 0.16 | 0.44 | 0.36 | −0.55 to 0.48 | 0.99 | 0.58 | 0.19 | 0.10 | 0.27 | 0.23 | −0.41 to 0.33 | 0.99 | 0.75 | |
Moderate | 0.32 | 0.19 | 0.52 | 0.42 | −0.7 to 0.55 | 0.99 | 0.27 | 0.24 | 0.16 | 0.44 | 0.36 | −0.59 to 0.36 | 0.99 | 0.81 | |
Severe | 0.51 | 0.28 | 0.77 | 0.58 | −1.04 to 0.98 | 0.99 | 0.79 | 0.39 | 0.25 | 0.69 | 0.52 | −0.78 to 0.76 | 0.99 | 0.84 | |
K2 (D) | Control | 0.23 | 0.13 | 0.36 | 0.30 | −0.39 to 0.53 | 0.98 | 0.21 | 0.14 | 0.09 | 0.24 | 0.20 | −0.23 to 0.33 | 0.99 | 0.19 |
Mild | 0.25 | 0.15 | 0.41 | 0.33 | −0.46 to 0.54 | 0.98 | 0.71 | 0.19 | 0.12 | 0.33 | 0.26 | −0.34 to 0.35 | 0.99 | 0.24 | |
Moderate | 0.34 | 0.19 | 0.52 | 0.39 | −0.77 to 0.55 | 0.98 | 0.12 | 0.23 | 0.13 | 0.36 | 0.30 | −0.52 to 0.37 | 0.99 | 0.31 | |
Severe | 0.67 | 0.29 | 0.80 | 0.57 | −1.55 to 1.06 | 0.98 | 0.11 | 0.54 | 0.24 | 0.66 | 0.46 | −1.15 to 0.97 | 0.99 | 0.46 | |
Kmax-A (D) | Control | 0.41 | 0.24 | 0.66 | 0.50 | −0.83 to 0.78 | 0.98 | 0.82 | 0.27 | 0.16 | 0.44 | 0.36 | −0.53 to 0.53 | 0.99 | 0.82 |
Mild | 0.47 | 0.26 | 0.72 | 0.52 | −0.82 to 1.04 | 0.98 | 0.38 | 0.43 | 0.24 | 0.66 | 0.48 | −0.84 to 0.84 | 0.99 | 0.74 | |
Moderate | 0.67 | 0.38 | 1.05 | 0.71 | −1.37 to 1.26 | 0.98 | 0.70 | 0.55 | 0.30 | 0.83 | 0.57 | −1.09 to 1.07 | 0.99 | 0.55 | |
Severe | 1.22 | 0.59 | 1.63 | 0.95 | −2.58 to 2.19 | 0.98 | 0.48 | 1.00 | 0.49 | 1.35 | 0.81 | −2.00 to 1.93 | 0.99 | 0.87 | |
Kmax-P (D) | Control | 0.06 | 0.03 | 0.08 | 0.51 | −0.13 to 0.12 | 0.99 | 0.68 | 0.05 | 0.03 | 0.08 | 0.41 | −0.09 to 0.11 | 0.99 | 0.33 |
Mild | 0.18 | 0.10 | 0.27 | 1.34 | −0.44 to 0.27 | 0.97 | 0.15 | 0.15 | 0.09 | 0.24 | 1.22 | −0.36 to 0.24 | 0.97 | 0.43 | |
Moderate | 0.26 | 0.14 | 0.38 | 1.65 | −0.50 to 0.53 | 0.96 | 0.66 | 0.17 | 0.09 | 0.24 | 1.45 | −0.35 to 0.33 | 0.97 | 0.49 | |
Severe | 0.30 | 0.17 | 0.47 | 1.71 | −0.49 to 0.65 | 0.96 | 0.17 | 0.28 | 0.14 | 0.38 | 1.53 | −0.51 to 0.59 | 0.97 | 0.54 | |
TCT (µm) | Control | 6.57 | 3.83 | 10.60 | 0.70 | −12.72 to 13.03 | 0.98 | 0.60 | 4.54 | 2.62 | 7.25 | 0.47 | −9.40 to 8.38 | 0.99 | 0.59 |
Mild | 6.85 | 3.67 | 10.16 | 0.74 | −11.86 to 14.99 | 0.98 | 0.38 | 6.20 | 3.46 | 9.46 | 0.68 | −10.42 to 13.88 | 0.98 | 0.34 | |
Moderate | 12.96 | 7.13 | 19.75 | 1.50 | −26.83 to 23.99 | 0.97 | 0.59 | 9.63 | 5.37 | 14.87 | 1.02 | −20.60 to 17.13 | 0.98 | 0.39 | |
Severe | 15.42 | 9.15 | 25.34 | 2.01 | −28.06 to 32.39 | 0.95 | 0.52 | 10.21 | 5.58 | 15.45 | 1.20 | −18.09 to 21.94 | 0.98 | 0.44 | |
CASIA SS-1000 | |||||||||||||||
K1 (D) | Control | 0.10 | 0.05 | 0.13 | 0.12 | −0.23 to 0.18 | 0.99 | 0.53 | 0.10 | 0.05 | 0.13 | 0.12 | −0.20 to 0.18 | 0.99 | 0.34 |
Mild | 0.16 | 0.10 | 0.27 | 0.23 | −0.40 to 0.23 | 0.99 | 0.08 | 0.15 | 0.08 | 0.22 | 0.18 | −0.32 to 0.25 | 0.99 | 0.54 | |
Moderate | 0.28 | 0.15 | 0.41 | 0.35 | −0.60 to 0.50 | 0.99 | 0.27 | 0.21 | 0.12 | 0.33 | 0.26 | −0.42 to 0.40 | 0.99 | 0.71 | |
Severe | 0.43 | 0.21 | 0.58 | 0.47 | −0.81 to 0.90 | 0.99 | 0.16 | 0.29 | 0.15 | 0.42 | 0.49 | −0.49 to 0.65 | 0.99 | 0.07 | |
K2 (D) | Control | 0.14 | 0.09 | 0.24 | 0.20 | −0.32 to 0.24 | 0.99 | 0.08 | 0.11 | 0.06 | 0.16 | 0.14 | −0.24 to 0.20 | 0.99 | 0.10 |
Mild | 0.15 | 0.09 | 0.25 | 0.21 | −0.36 to 0.24 | 0.99 | 0.34 | 0.15 | 0.10 | 0.27 | 0.20 | −0.35 to 0.24 | 0.99 | 0.37 | |
Moderate | 0.22 | 0.12 | 0.33 | 0.25 | −0.51 to 0.36 | 0.99 | 0.10 | 0.20 | 0.10 | 0.28 | 0.21 | −0.47 to 0.31 | 0.99 | 0.42 | |
Severe | 0.39 | 0.24 | 0.66 | 0.49 | −0.68 to 0.86 | 0.99 | 0.15 | 0.30 | 0.16 | 0.44 | 0.32 | −0.57 to 0.62 | 0.99 | 0.09 | |
Kmax-A (D) | Control | 0.30 | 0.15 | 0.42 | 0.34 | −0.64 to 0.55 | 0.98 | 0.51 | 0.20 | 0.11 | 0.30 | 0.22 | −0.41 to 0.37 | 0.99 | 0.64 |
Mild | 0.35 | 0.20 | 0.55 | 0.42 | −0.64 to 0.72 | 0.98 | 0.55 | 0.22 | 0.13 | 0.36 | 0.23 | −0.42 to 0.43 | 0.99 | 0.62 | |
Moderate | 0.47 | 0.24 | 0.66 | 0.46 | −0.97 to 0.88 | 0.98 | 0.10 | 0.42 | 0.23 | 0.63 | 0.45 | −0.90 to 0.74 | 0.99 | 0.22 | |
Severe | 0.72 | 0.37 | 1.02 | 0.69 | −1.26 to 1.57 | 0.98 | 0.21 | 0.71 | 0.36 | 0.99 | 0.68 | −1.20 to 1.57 | 0.99 | 0.08 | |
Kmax-P (D) | Control | 0.06 | 0.02 | 0.05 | 0.29 | −0.13 to 0.11 | 0.99 | 0.21 | 0.06 | 0.02 | 0.05 | 0.29 | −0.14 to 0.10 | 0.99 | 0.13 |
Mild | 0.08 | 0.02 | 0.05 | 0.32 | −0.17 to 0.14 | 0.98 | 0.17 | 0.06 | 0.02 | 0.05 | 0.32 | −0.13 to 0.11 | 0.99 | 0.19 | |
Moderate | 0.07 | 0.03 | 0.08 | 0.39 | −0.15 to 0.12 | 0.98 | 0.20 | 0.07 | 0.03 | 0.08 | 0.38 | −0.14 to 0.12 | 0.99 | 0.39 | |
Severe | 0.15 | 0.08 | 0.22 | 0.68 | −0.34 to 0.23 | 0.98 | 0.11 | 0.09 | 0.05 | 0.13 | 0.53 | −0.23 to 0.14 | 0.99 | 0.42 | |
TCT (µm) | Control | 2.98 | 1.46 | 4.04 | 0.27 | −6.03 to 5.67 | 0.99 | 0.75 | 2.44 | 1.36 | 3.76 | 0.25 | −4.85 to 4.70 | 0.99 | 0.73 |
Mild | 3.71 | 2.37 | 6.56 | 0.50 | −6.81 to 7.73 | 0.99 | 0.42 | 2.72 | 1.90 | 5.26 | 0.39 | −4.41 to 6.25 | 0.99 | 0.41 | |
Moderate | 4.67 | 2.74 | 7.58 | 0.60 | −7.36 to 10.85 | 0.99 | 0.44 | 4.24 | 2.51 | 6.95 | 0.55 | −6.61 to 10.00 | 0.99 | 0.25 | |
Severe | 5.91 | 2.75 | 7.61 | 0.64 | −12.42 to 10.94 | 0.99 | 0.45 | 5.42 | 2.74 | 7.58 | 0.63 | −10.81 to 10.42 | 0.99 | 0.43 |
Cut-Off for Corneal Consistent Change | |||||
---|---|---|---|---|---|
PENTACAM | CASIA SS-1000 | ||||
Parameter | Group | Single Measurement (Method 1) | Repeated Measurements (Method 2) | Single Measurement (Method 1) | Repeated Measurements (Method 2) |
K1 (D) | Control | 0.53 | 0.48 | 0.26 | 0.25 |
Mild | 0.72 | 0.50 | 0.38 | 0.37 | |
Moderate | 0.78 | 0.54 | 0.70 | 0.53 | |
Severe | 1.40 | 1.09 | 1.25 | 0.88 | |
K2 (D) | Control | 0.72 | 0.44 | 0.35 | 0.29 |
Mild | 0.77 | 0.51 | 0.38 | 0.37 | |
Moderate | 0.80 | 0.53 | 0.51 | 0.46 | |
Severe | 1.60 | 1.41 | 1.17 | 0.87 | |
Kmax-A (D) | Control | 1.12 | 0.75 | 0.80 | 0.54 |
Mild | 1.48 | 1.24 | 1.04 | 0.65 | |
Moderate | 1.74 | 1.46 | 1.22 | 1.04 | |
Severe | 3.18 | 2.74 | 2.16 | 2.15 | |
Kmax-P (D) | Control | 0.17 | 0.15 | 0.15 | 0.15 |
Mild | 0.44 | 0.38 | 0.22 | 0.17 | |
Moderate | 0.72 | 0.45 | 0.17 | 0.17 | |
Severe | 0.88 | 0.82 | 0.35 | 0.22 | |
TCT (µm) | Control | 18.38 | 12.07 | 7.65 | 7.34 |
Mild | 21.36 | 19.64 | 11.19 | 8.78 | |
Moderate | 33.26 | 24.01 | 14.29 | 13.03 | |
Severe | 42.65 | 28.68 | 15.55 | 14.83 |
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Ortiz-Toquero, S.; Fuente, C.; Auladell, C.; Arnalich-Montiel, F. Influence of Keratoconus Severity on Detecting True Progression with Scheimpflug Imaging and Anterior Segment Optical Coherence Tomography. Life 2023, 13, 1474. https://doi.org/10.3390/life13071474
Ortiz-Toquero S, Fuente C, Auladell C, Arnalich-Montiel F. Influence of Keratoconus Severity on Detecting True Progression with Scheimpflug Imaging and Anterior Segment Optical Coherence Tomography. Life. 2023; 13(7):1474. https://doi.org/10.3390/life13071474
Chicago/Turabian StyleOrtiz-Toquero, Sara, Carlota Fuente, Clara Auladell, and Francisco Arnalich-Montiel. 2023. "Influence of Keratoconus Severity on Detecting True Progression with Scheimpflug Imaging and Anterior Segment Optical Coherence Tomography" Life 13, no. 7: 1474. https://doi.org/10.3390/life13071474
APA StyleOrtiz-Toquero, S., Fuente, C., Auladell, C., & Arnalich-Montiel, F. (2023). Influence of Keratoconus Severity on Detecting True Progression with Scheimpflug Imaging and Anterior Segment Optical Coherence Tomography. Life, 13(7), 1474. https://doi.org/10.3390/life13071474