PURPOSE To evaluate an automated method for detecting the cone shape characteristics and to assess the cornea specialists' subjective variability of these measures using different maps. METHODS Topographic images of the anterior and posterior surface of each eye were presented to 12 clinicians in two different types of map: tangential curvature and relative elevation to the best-fit sphere. They were asked to mark the cone center and its boundaries in the two maps without knowing that they belonged to the same patient. The results between the maps were compared to assess the subjective variability dependent on the map type and the automated method was compared against both estimations to assess its accuracy. RESULTS Considering the results of anterior and posterior surfaces, there was low agreement between the cone center estimations using different types of maps for 10 of the 12 cases (P < .05), whereas the comparison between the automated method and the two map estimations did not show differences in 11 of the 12 cases (P > .05). There was high variability, up to 55%, among clinicians' estimations of the cone area. The results of the automated method were within the range of the expert's estimations. CONCLUSIONS An objective, mathematically derived method of determining morphological dimensions of the cone was consistent with clinicians' evaluations. Although there was high variability among the experts' subjective estimates, which were highly influenced by the type of map, the objective method provided a reliable evaluation of the keratoconus shape independent of maps or color scale. [J Refract Surg. 2021;37(6):414-421.].

中文翻译：

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圆锥角膜锥体大小和中心自动表征的临床验证。

目的评估用于检测锥体形状特征的自动化方法，并使用不同的地图评估角膜专家对这些措施的主观可变性。方法 将每只眼睛的前表面和后表面的地形图像以两种不同类型的地图呈现给 12 位临床医生：切向曲率和与最佳拟合球体的相对高度。他们被要求在两张地图中标记锥体中心及其边界，但不知道它们属于同一患者。比较地图之间的结果以评估依赖于地图类型的主观可变性，并将自动化方法与两种估计进行比较以评估其准确性。结果 考虑前后表面的结果，对于 12 个案例中的 10 个，使用不同类型地图的锥体中心估计之间的一致性较低（P < .05），而自动化方法与两种地图估计之间的比较在 12 个案例中的 11 个中没有显示差异（ P > .05）。临床医生对锥体面积的估计存在高变异性，高达 55%。自动化方法的结果在专家估计的范围内。结论 确定锥体形态尺寸的客观、数学推导的方法与临床医生的评估一致。尽管专家的主观估计存在很大差异，受地图类型的影响很大，但客观方法提供了独立于地图或色标的圆锥角膜形状的可靠评估。[J 屈光手术。2021;37(6):414-421.]。