Average lens density quantification with swept‐source optical coherence tomography: optimized, automated cataract grading technique. Issue 12 (December 2019)

• Record Type: Journal Article
• Authors: Panthier, Christophe; de Wazieres, Alice; Rouger, Helene; Moran, Sarah; Saad, Alain; Gatinel, Damien
• Is Part Of: Journal of cataract and refractive surgery. Volume 45:Issue 12(2019)
• Publication Date: 2019-12
• Subjects: 617.7
• DOI: 10.1016/j.jcrs.2019.07.033
• Languages: English
• ISSNs: 0886-3350

Abstract

Abstract : Purpose: : To assess a revised version of an objective cataract grading method based on the lens densitometry on sweptsource optical coherence tomography (SS‐OCT) scans. Setting: : Rothschild Foundation, Paris, France. Design: : Prospective case series. Methods: : All patients seeking a cataract evaluation and consenting to study participation were included. Exclusion criteria were a history of ocular surgery, cornea or retina disorders, and ocular dryness. The average lens densitometry (ALD) was measured on SS‐OCT scans (IOLMaster 700) using an algorithm developed with MATLAB software. The ocular scatter index (OSI), measured using a double‐pass aberrometer (Optical Quality Analysis System); Pentacam nucleus staging (PNS) score; and mean PNS were also measured and compared with the ALD measurements. Results: : Two hundred eighty‐five eyes (195 with cataract; 90 controls) of 155 patients aged 20 to 93 years (mean 56.5 years ± 21 [SD]) were included. The ALD measurements were repeatable ( P = .99, analysis of variance). The repeatability limit was 2.50 pixel units. The ALD correlated with the OSI ( r 2 = 0.41, P < .01) and PNS score ( r 2 = 0.65, P < .01). An ALD greater than 73.8 pixel units was the cutoff threshold for cataract, with 96.2% sensitivity and 91.3% specificity. Discriminant analysis produced a model combining visual acuity and the mean ALD with an area under the receiver operating characteristic curve of 0.975 ( P < .001), where the mean ALD had the highest coefficient. Conclusions: : Using the automated algorithm based on SS‐OCT ALD measurements was a repeatable, reliable objective cataract grading method. When the ALD is greater than 73.8 pixel units, it is reasonable to discuss cataract surgery in symptomatic patients.