Optical coherence tomography in the diagnostics of keratoconus
Abstract
Objective. To evaluate the effectiveness of optical coherence tomography in the diagnosis of keratoconus, and to establish reliable indicators for diagnosing keratoconus. Materials and methods: The study included data from 142 people (280 eyes) divided into four groups: Group 1 — 63 eyes (32 people) of patients with refractive errors; Group 2 — 181 eyes (91 people), patients with a confirmed diagnosis of grade 1—3 keratoconus (according to Amsler); Group 3 — 36 eyes (19 people), healthy volunteers without ophthalmological pathology; The 4th group represents the combined data of the 1st and 3rd groups — 99 eyes (51 people). Results and conclusions. ROC-analysis data of the most reliable indicators: central corneal thickness (CCT), minimum corneal thickness (MCT), difference in pachymetry (DP) and difference in the epithelium (DE). Threshold level of CCT 515 µm with AUC ROC-curve 0,862 (95 % CI (0.816—0.900); p < 0.0001), Se = 79.0 % and Sp = 78.8 %, threshold level of MCT 483 µm with AUC ROC curve 0,922 (95 % CI (0.884—0.951); p < 0.0001), Se = 75.1 % and Sp = 90.9 %. The cut-off point of the difference indicators was as follows: DP 15 μm AUC ROC-curve 0,936 (95 % CI (0.901—0.962); p < 0.0001), Se = 88.4 % and Sp = 89.9 %, DE 5 µm AUC ROC-curve 0.893 (95 % CI (0.851—0.927); p < 0.0001), Se = 79.56 % and Sp = 89.86 %. Optical coherence tomography is a highly informative, reliable and accurate method for examining the cornea and diagnosing keratoconus. The most reliable and accurate indicators for diagnosing keratoconus using optical coherence tomography are: CCT ≤ 512 µm, MCT ≤ 483 µm, DP > 18 µm and DE > 5 µm. Exceeding these threshold levels will indicate that the patient is diagnosed with keratoconus. The proposed method for diagnosing keratoconus using optical coherence tomography can be widely used by ophthalmologists in the clinical practice of healthcare institutions providing care in the field of ophthalmology.
About the Authors
L. A. Stolyarova,
10-я городская клиническая больница; ИПК и ПКЗ УО «Белорусский государственный медицинский университет»
Belarus
Belarus
T. A. Imshanetskaya,
ИПК и ПКЗ УО «Белорусский государственный медицинский университет»
Belarus
Belarus
D. E. Abelski
ИПК и ПКЗ УО «Белорусский государственный медицинский университет»; 3ООО «МедВайз» — Центр михрохирургии глаза VOKA
Belarus
Belarus
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Review
For citations:
Stolyarova, L.A., Imshanetskaya, T.A., Abelski D.E. Optical coherence tomography in the diagnostics of keratoconus. Healthcare. 2024;(9):10-18. (In Russ.)
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