Purpose

To assess a revised version of an objective cataract grading method based on the lens densitometry on swept-source optical coherence tomography (SS-OCT) scans.

Setting

Rothschild Foundation, Paris, France.

Design

Prospective case series.

Methods

All patients seeking a cataract evaluation and consenting to study participation were included. Exclusion criteria were a history of ocular surgery, cornea or retina disorders, and ocular dryness. The average lens densitometry (ALD) was measured on SS-OCT scans (IOLMaster 700) using an algorithm developed with MATLAB software. The ocular scatter index (OSI), measured using a double-pass aberrometer (Optical Quality Analysis System); Pentacam nucleus staging (PNS) score; and mean PNS were also measured and compared with the ALD measurements.

Results

Two hundred eighty-five eyes (195 with cataract; 90 controls) of 155 patients aged 20 to 93 years (mean 56.5 years ± 21 [SD]) were included. The ALD measurements were repeatable (P = .99, analysis of variance). The repeatability limit was 2.50 pixel units. The ALD correlated with the OSI (r² = 0.41, P < .01) and PNS score (r² = 0.65, P < .01). An ALD greater than 73.8 pixel units was the cutoff threshold for cataract, with 96.2% sensitivity and 91.3% specificity. Discriminant analysis produced a model combining visual acuity and the mean ALD with an area under the receiver operating characteristic curve of 0.975 (P < .001), where the mean ALD had the highest coefficient.

Conclusions

Using the automated algorithm based on SS-OCT ALD measurements was a repeatable, reliable objective cataract grading method. When the ALD is greater than 73.8 pixel units, it is reasonable to discuss cataract surgery in symptomatic patients.

中文翻译：

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扫频光学相干断层扫描技术对平均晶状体密度进行定量：优化的自动白内障分级技术

目的

评估基于镜头密度法在扫描源光学相干断层扫描（SS-OCT）扫描上的客观白内障分级方法的修订版。

设置

法国巴黎罗斯柴尔德基金会。

设计

预期案例系列。

方法

包括所有寻求白内障评估并同意参加研究的患者。排除标准是眼科手术，角膜或视网膜疾病和眼干燥的病史。使用由MATLAB软件开发的算法，在SS-OCT扫描（IOLMaster 700）上测量平均镜片密度（ALD）。使用双通道像差仪（光学质量分析系统）测量的眼散射指数（OSI）；Pentacam核分期（PNS）评分；还测量了平均PNS，并将其与ALD测量值进行了比较。

结果

纳入155名年龄在20至93岁（平均56.5岁±21 [SD]）的患者中的285只眼（白内障195只； 90名对照组）。ALD测量是可重复的（P  = .99，方差分析）。重复性极限为2.50像素单位。ALD与OSI（r ²  = 0.41，P  <.01）和PNS评分（r ²  = 0.65，P  <.01）相关。大于73.8像素单位的ALD是白内障的临界阈值，灵敏度为96.2％，特异性为91.3％。判别分析产生了一个模型，该模型结合了视敏度和平均ALD，接收器工作特性曲线下的面积为0.975（P <.001），其中平均ALD具有最高系数。

结论

使用基于SS-OCT ALD测量的自动化算法是一种可重复的，可靠的客观白内障分级方法。当ALD大于73.8像素单位时，讨论有症状患者的白内障手术是合理的。