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목적 : To evaluate the efficacy of indices in Scheimpflug tomography on detecting very early stage of keratoconus using highly asymmetric keratoconus data.
방법 : We evaluated 100 normal eyes in the control group and 20 less affected keratoconus eyes from 20 patients in the subclinical keratoconus group, and retrospectively compared central and regional corneal thickness data as well as data from the Belin/Ambrosio display. Data from this map was labeled as normal, suspicious and abnormal per the device display. Those data were processed with T test and ROC curve analysis.
결과 : There were no significant differences in age and sex between groups. For the Enhanced Ectasia display, both ARTmax and D score were significantly different between groups. But using the device screening scoring, ARTmax missed 75% subclinical KC patients and it’s Area Under Curve value was only 0.168, which is much less than chance. The D score was better, but it also missed 40% of subclinical KC patients. It’s area under curve value was 0.863, which was also worse than has been reported. Using both ARTmax and D score in combination, 40% of subclinical KC eyes were considered normal.
결론 : Group averages for thickness measures and the enhanced ectasia display map were significantly different, meaning that these measurements do help identifying groups. However, none of the basic thickness metrics were effective in classifying an individual eye as either normal or as subclinical keratoconus. ARTmax had a worse area under the curve than chance, further demonstrating that thickness variables did not help in screening individual patients in this study. The D score faired better than all other tomographic metrics, but worse than has been reported.
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