Validation of the multi-metric D-index change in the assessment of keratoconus progression.
Int Ophthalmol
; 42(9): 2665-2671, 2022 Sep.
Article
em En
| MEDLINE
| ID: mdl-35381894
ABSTRACT
PURPOSE:
To validate the effectiveness of the multi-metric D-index by Pentacam in detecting keratoconus (KC) progression. MATERIALS ANDMETHODS:
This was a retrospective study of KC patients at the Rabin Medical Center, Petah Tikva, Israel, during 2016-2018 with at least two corneal tomography examinations six months apart. Agreement between clinical diagnosis of progression (1.5D increase in mean keratometric value, 1D increase in Kmax, a 5% decrease in central corneal thickness (CCT), worsening of visual acuity by more than one line, or deterioration of manifest corneal astigmatism > 1.5D) and the D-index was evaluated. Receiver operating characteristic (ROC) analysis was used to find the D-index's optimal cutoff value to show progression.RESULTS:
We included KC eyes in the stable group (N = 7) and the progression group (N = 54). Patient demographics and tomographic parameters at baseline were similar between the groups. The D-index change was significantly higher in the progression group than in the stable group (median + 1 and 0.0, respectively, p = 0.024). Based on the ROC analysis, the optimal D-index cutoff change within at least six months was 0.32 (59.3% sensitivity and 100% specificity (area under the curve [AUC] = 0.771, Youden = 0.592). Subjects with a D-index change above this value had a 21.1-fold increase in odds for corneal ectasia progression requiring CXL (OR 21.1, 95%CI 1.17-398.8, p = 0.038).CONCLUSION:
The multi-metric D-index can serve as a clinically feasible parameter to detect KC progression and guide patients' referral for further interventions.Palavras-chave
Texto completo:
1
Coleções:
01-internacional
Base de dados:
MEDLINE
Assunto principal:
Ceratocone
Tipo de estudo:
Observational_studies
/
Prognostic_studies
Limite:
Humans
Idioma:
En
Ano de publicação:
2022
Tipo de documento:
Article