Prediction of Best-Corrected Visual Acuity With Swept-Source Optical Coherence Tomography Parameters in Keratoconus. Issue 9 (September 2019) - Esaka, Yuri
Abstract : Purpose: This study aimed to predict the best-corrected visual acuity (BCVA) based on swept-source optical coherence tomography (SS-OCT) parameters in eyes with keratoconus. Methods: We retrospectively reviewed 135 eyes of 135 patients with keratoconus (mean age: 31.9 ± 12.4 years). The average keratometry value and BCVA (logarithm of the minimal angle of resolution [Snellen]) were 48.68 ± 5.44 diopter and 0.20 ± 0.36 (20/25), respectively. Eleven parameters were calculated using SS-OCT. Apart from the corneal height and elevation, all the other parameters were calculated from both anterior and posterior corneal OCT data. The patients were divided into 2 groups, 1 for creating the prediction equation (prediction group, 86 eyes) and another for verifying the equation (verification group, 49 eyes). In the former, individual correlations between the BCVA and SS-OCT parameters were analyzed. A stepwise multiple regression analysis was performed with the BCVA as a dependent variable and SS-OCT parameters as independent variables. After its creation, the accuracy of the prediction equation was verified in the verification group. Results: All the parameters, except for age and total corneal cylinder, showed statistically significant correlations with BCVA ( P < 0.0001). Using the stepwise multiple regression analysis, we selected 2 explanatory variables: root mean square of anterior corneal elevation (standardized regression coefficient: 1.221; P < 0.0001) and total coma aberration (standardized regression coefficient: −0.575; P = 0.001; adjusted R 2 = 0.546). The prediction was correct in 84.6% of the eyes within ±1 line of Snellen BCVA. Conclusions: Using the equation we derived from SS-OCT parameters is a promising method to predict visual function in patients with keratoconus. Abstract : Supplemental Digital Content is Available in the Text.