Prognostic Nomograms Predicting Risk of Keratoconus in Very Asymmetric Ectasia: Combined Corneal Tomographic and Biomechanical Assessments
Purpose: The aim of the study was to develop and validate a prognostic nomogram for subclinical keratoconus diagnosis using corneal tomographic and biomechanical integration assessments.Design: This is a retrospective case–control study.Methods:Setting: The study was carried out in a hospital settin...
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Frontiers Media S.A.
2022-02-01
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| Series: | Frontiers in Bioengineering and Biotechnology |
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| Online Access: | https://www.frontiersin.org/articles/10.3389/fbioe.2022.839545/full |
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| author | Xiaoyu Zhang Xiaoyu Zhang Xiaoyu Zhang Xiaoyu Zhang Lan Ding Lan Ding Lan Ding Lan Ding Ling Sun Ling Sun Ling Sun Ling Sun Yangyi Huang Yangyi Huang Yangyi Huang Yangyi Huang Tian Han Tian Han Tian Han Tian Han Yishan Qian Yishan Qian Yishan Qian Yishan Qian Xingtao Zhou Xingtao Zhou Xingtao Zhou Xingtao Zhou |
| author_facet | Xiaoyu Zhang Xiaoyu Zhang Xiaoyu Zhang Xiaoyu Zhang Lan Ding Lan Ding Lan Ding Lan Ding Ling Sun Ling Sun Ling Sun Ling Sun Yangyi Huang Yangyi Huang Yangyi Huang Yangyi Huang Tian Han Tian Han Tian Han Tian Han Yishan Qian Yishan Qian Yishan Qian Yishan Qian Xingtao Zhou Xingtao Zhou Xingtao Zhou Xingtao Zhou |
| author_sort | Xiaoyu Zhang |
| collection | DOAJ |
| description | Purpose: The aim of the study was to develop and validate a prognostic nomogram for subclinical keratoconus diagnosis using corneal tomographic and biomechanical integration assessments.Design: This is a retrospective case–control study.Methods:Setting: The study was carried out in a hospital setting. Patients: The study included patients with very asymmetric ectasia (VAE) and normal controls. Patients with VAE had defined clinical ectasia in one eye and normal topography (VAE-NT) in the fellow eye, and VAE-NT eyes were selected for analysis. VAE-NT was defined as stratified stage 0 using the ABCD keratoconus grading system. The normal control group was selected from corneal refractive surgery candidates at our clinic, and the right eye was enrolled. Observation Procedures: Scheimpflug-based corneal tomography (Pentacam) and corneal biomechanical assessment (Corvis ST) were performed. Main Outcome Measures: We performed multiple logistic regression analysis and constructed a simple nomogram via the stepwise method. The receiver operating characteristic (ROC) curve and discrimination and calibration of prognostic nomogram were performed by 500 bootstrap resamplings to assess the determination and clinical value, respectively.Results: A total of 59 VAE-NT and 142 normal eyes were enrolled. For differentiating normal and VAE-NT eyes, the values of specificity, sensitivity, and area under the ROC (AUROC) were 0.725, 0.610, and 0.713 for tomographic parameters, 0.886, 0.632, and 0.811 for biomechanical parameters, and 0.871, 0.754, and 0.849 for combined parameters, respectively. Combined parameters showed better predictability than separated tomographic or biomechanical parameters.Conclusion: Our nomogram developed with combined tomographic and biomechanical parameters demonstrated a plausible, capable, and widely implementable tool to predict risk of keratoconus. The identification of at-risk patients can provide advanced strategies to epitomize ectasia susceptibility. |
| first_indexed | 2024-12-13T03:22:16Z |
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| language | English |
| last_indexed | 2024-12-13T03:22:16Z |
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| spelling | doaj.art-aa44ec244fe94aab9002bbd5f35a7dc02022-12-22T00:01:20ZengFrontiers Media S.A.Frontiers in Bioengineering and Biotechnology2296-41852022-02-011010.3389/fbioe.2022.839545839545Prognostic Nomograms Predicting Risk of Keratoconus in Very Asymmetric Ectasia: Combined Corneal Tomographic and Biomechanical AssessmentsXiaoyu Zhang0Xiaoyu Zhang1Xiaoyu Zhang2Xiaoyu Zhang3Lan Ding4Lan Ding5Lan Ding6Lan Ding7Ling Sun8Ling Sun9Ling Sun10Ling Sun11Yangyi Huang12Yangyi Huang13Yangyi Huang14Yangyi Huang15Tian Han16Tian Han17Tian Han18Tian Han19Yishan Qian20Yishan Qian21Yishan Qian22Yishan Qian23Xingtao Zhou24Xingtao Zhou25Xingtao Zhou26Xingtao Zhou27Eye Institute and Department of Ophthalmology, Eye & ENT Hospital, Fudan University, Shanghai, ChinaNHC Key Laboratory of Myopia (Fudan University), Shanghai, ChinaKey Laboratory of Myopia, Chinese Academy of Medical Sciences, Shanghai, ChinaShanghai Research Center of Ophthalmology and Optometry, Shanghai, ChinaEye Institute and Department of Ophthalmology, Eye & ENT Hospital, Fudan University, Shanghai, ChinaNHC Key Laboratory of Myopia (Fudan University), Shanghai, ChinaKey Laboratory of Myopia, Chinese Academy of Medical Sciences, Shanghai, ChinaShanghai Research Center of Ophthalmology and Optometry, Shanghai, ChinaEye Institute and Department of Ophthalmology, Eye & ENT Hospital, Fudan University, Shanghai, ChinaNHC Key Laboratory of Myopia (Fudan University), Shanghai, ChinaKey Laboratory of Myopia, Chinese Academy of Medical Sciences, Shanghai, ChinaShanghai Research Center of Ophthalmology and Optometry, Shanghai, ChinaEye Institute and Department of Ophthalmology, Eye & ENT Hospital, Fudan University, Shanghai, ChinaNHC Key Laboratory of Myopia (Fudan University), Shanghai, ChinaKey Laboratory of Myopia, Chinese Academy of Medical Sciences, Shanghai, ChinaShanghai Research Center of Ophthalmology and Optometry, Shanghai, ChinaEye Institute and Department of Ophthalmology, Eye & ENT Hospital, Fudan University, Shanghai, ChinaNHC Key Laboratory of Myopia (Fudan University), Shanghai, ChinaKey Laboratory of Myopia, Chinese Academy of Medical Sciences, Shanghai, ChinaShanghai Research Center of Ophthalmology and Optometry, Shanghai, ChinaEye Institute and Department of Ophthalmology, Eye & ENT Hospital, Fudan University, Shanghai, ChinaNHC Key Laboratory of Myopia (Fudan University), Shanghai, ChinaKey Laboratory of Myopia, Chinese Academy of Medical Sciences, Shanghai, ChinaShanghai Research Center of Ophthalmology and Optometry, Shanghai, ChinaEye Institute and Department of Ophthalmology, Eye & ENT Hospital, Fudan University, Shanghai, ChinaNHC Key Laboratory of Myopia (Fudan University), Shanghai, ChinaKey Laboratory of Myopia, Chinese Academy of Medical Sciences, Shanghai, ChinaShanghai Research Center of Ophthalmology and Optometry, Shanghai, ChinaPurpose: The aim of the study was to develop and validate a prognostic nomogram for subclinical keratoconus diagnosis using corneal tomographic and biomechanical integration assessments.Design: This is a retrospective case–control study.Methods:Setting: The study was carried out in a hospital setting. Patients: The study included patients with very asymmetric ectasia (VAE) and normal controls. Patients with VAE had defined clinical ectasia in one eye and normal topography (VAE-NT) in the fellow eye, and VAE-NT eyes were selected for analysis. VAE-NT was defined as stratified stage 0 using the ABCD keratoconus grading system. The normal control group was selected from corneal refractive surgery candidates at our clinic, and the right eye was enrolled. Observation Procedures: Scheimpflug-based corneal tomography (Pentacam) and corneal biomechanical assessment (Corvis ST) were performed. Main Outcome Measures: We performed multiple logistic regression analysis and constructed a simple nomogram via the stepwise method. The receiver operating characteristic (ROC) curve and discrimination and calibration of prognostic nomogram were performed by 500 bootstrap resamplings to assess the determination and clinical value, respectively.Results: A total of 59 VAE-NT and 142 normal eyes were enrolled. For differentiating normal and VAE-NT eyes, the values of specificity, sensitivity, and area under the ROC (AUROC) were 0.725, 0.610, and 0.713 for tomographic parameters, 0.886, 0.632, and 0.811 for biomechanical parameters, and 0.871, 0.754, and 0.849 for combined parameters, respectively. Combined parameters showed better predictability than separated tomographic or biomechanical parameters.Conclusion: Our nomogram developed with combined tomographic and biomechanical parameters demonstrated a plausible, capable, and widely implementable tool to predict risk of keratoconus. The identification of at-risk patients can provide advanced strategies to epitomize ectasia susceptibility.https://www.frontiersin.org/articles/10.3389/fbioe.2022.839545/fullasymmetric ectasiakeratoconusprognostic nomogramdiagnosiscorneabiomechanical |
| spellingShingle | Xiaoyu Zhang Xiaoyu Zhang Xiaoyu Zhang Xiaoyu Zhang Lan Ding Lan Ding Lan Ding Lan Ding Ling Sun Ling Sun Ling Sun Ling Sun Yangyi Huang Yangyi Huang Yangyi Huang Yangyi Huang Tian Han Tian Han Tian Han Tian Han Yishan Qian Yishan Qian Yishan Qian Yishan Qian Xingtao Zhou Xingtao Zhou Xingtao Zhou Xingtao Zhou Prognostic Nomograms Predicting Risk of Keratoconus in Very Asymmetric Ectasia: Combined Corneal Tomographic and Biomechanical Assessments Frontiers in Bioengineering and Biotechnology asymmetric ectasia keratoconus prognostic nomogram diagnosis cornea biomechanical |
| title | Prognostic Nomograms Predicting Risk of Keratoconus in Very Asymmetric Ectasia: Combined Corneal Tomographic and Biomechanical Assessments |
| title_full | Prognostic Nomograms Predicting Risk of Keratoconus in Very Asymmetric Ectasia: Combined Corneal Tomographic and Biomechanical Assessments |
| title_fullStr | Prognostic Nomograms Predicting Risk of Keratoconus in Very Asymmetric Ectasia: Combined Corneal Tomographic and Biomechanical Assessments |
| title_full_unstemmed | Prognostic Nomograms Predicting Risk of Keratoconus in Very Asymmetric Ectasia: Combined Corneal Tomographic and Biomechanical Assessments |
| title_short | Prognostic Nomograms Predicting Risk of Keratoconus in Very Asymmetric Ectasia: Combined Corneal Tomographic and Biomechanical Assessments |
| title_sort | prognostic nomograms predicting risk of keratoconus in very asymmetric ectasia combined corneal tomographic and biomechanical assessments |
| topic | asymmetric ectasia keratoconus prognostic nomogram diagnosis cornea biomechanical |
| url | https://www.frontiersin.org/articles/10.3389/fbioe.2022.839545/full |
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