Enhanced Combined Tomography and Biomechanics Data for Distinguishing Forme Fruste Keratoconus

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dc.citation.issue7
dc.citation.volume32
dc.contributor.authorLuz, Allan [UNIFESP]
dc.contributor.authorLopes, Bernardo
dc.contributor.authorHallahan, Katie M.
dc.contributor.authorValbon, Bruno
dc.contributor.authorRamos, Isaac
dc.contributor.authorFaria-Correia, Fernando
dc.contributor.authorSchor, Paulo [UNIFESP]
dc.contributor.authorDupps, William J., Jr.
dc.contributor.authorAmbrosio, Renato, Jr. [UNIFESP]
dc.coverageThorofare
dc.date.accessioned2020-08-14T13:44:20Z
dc.date.available2020-08-14T13:44:20Z
dc.date.issued2016
dc.description.abstractPURPOSE: To evaluate the performance of the Ocular Response Analyzer (ORA) (Reichert Ophthalmic Instruments, Depew, NY) variables and Pentacam HR (Oculus Optikgerate GmbH, Wetzlar, Germany) tomographic parameters in differentiating forme fruste keratoconus (FFKC) from normal corneas, and to assess a combined biomechanical and tomographic parameter to improve outcomes. METHODS: Seventy-six eyes of 76 normal patients and 21 eyes of 21 patients with FFKC were included in the study. Fifteen variables were derived from exported ORA signals to characterize putative indicators of biomechanical behavior and 37 ORA waveform parameters were tested. Sixteen tomographic parameters from Pentacam HR were tested. Logistic regression was used to produce a combined biomechanical and tomography linear model. Differences between groups were assessed by the Mann-Whitney U test. The area under the receiver operating characteristics curve (AUROC) was used to compare diagnostic performance. RESULTS: No statistically significant differences were found in age, thinnest point, central corneal thickness, and maximum keratometry between groups. Twenty-one parameters showed significant differences between the FFKC and control groups. Among the ORA waveform measurements, the best parameters were those related to the area under the first peak, p1area1 (AUROC, 0.717 +/- 0.065). Among the investigator ORA variables, a measure incorporating the pressure-deformation relationship of the entire response cycle was the best predictor (hysteresis loop area, AUROC, 0.688 +/- 0.068). Among tomographic parameters, Belin/Ambrosio display showed the highest predictive value (AUROC, 0.91 +/- 0.057). A combination of parameters showed the best result (AUROC, 0.953 +/- 0.024) outperforming individual parameters. CONCLUSIONS: Tomographic and biomechanical parameters demonstrated the ability to differentiate FFKC from normal eyes. A combination of both types of information further improved predictive value.en
dc.description.affiliationUniv Fed Sao Paulo, Dept Ophthalmol, Sao Paulo, Brazil
dc.description.affiliationCleveland Clin, Cole Eye Inst, Cleveland, OH 44106 USA
dc.description.affiliationCleveland Clin, Lerner Res Inst, Biomed Engn, Cleveland, OH 44106 USA
dc.description.affiliationUniv Sao Paulo, Dept Ophthalmol, Sao Paulo, Brazil
dc.description.affiliationHosp Olhos Sergipe, Cornea & Refract Surg Dept, Aracaju, Brazil
dc.description.affiliationHosp Braga, Cornea & Refract Surg Dept, Braga, Portugal
dc.description.affiliationRio de Janeiro Corneal Tomog & Biomech Study Grp, Rio De Janeiro, Brazil
dc.description.affiliationInst Olhos Renato Ambrosio & Visare Personal Lase, Rio De Janeiro, Brazil
dc.description.affiliationUnifespUniv Fed Sao Paulo, Dept Ophthalmol, Sao Paulo, Brazil
dc.description.sourceWeb of Science
dc.description.sponsorshipNIH
dc.description.sponsorshipZiemer
dc.description.sponsorshipIDNIH: R01EY023381
dc.format.extent479-+
dc.identifierhttp://dx.doi.org/10.3928/1081597X-20160502-02
dc.identifier.citationJournal Of Refractive Surgery. Thorofare, v. 32, n. 7, p. 479-+, 2016.
dc.identifier.doi10.3928/1081597X-20160502-02
dc.identifier.fileWOS000384898300008.pdf
dc.identifier.issn1081-597X
dc.identifier.urihttps://repositorio.unifesp.br/handle/11600/57602
dc.identifier.wosWOS:000384898300008
dc.language.isoeng
dc.publisherSlack Inc
dc.relation.ispartofJournal Of Refractive Surgery
dc.rightsinfo:eu-repo/semantics/openAccess
dc.titleEnhanced Combined Tomography and Biomechanics Data for Distinguishing Forme Fruste Keratoconusen
dc.typeinfo:eu-repo/semantics/article
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