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. 2022 Oct 4;12(10):2406.
doi: 10.3390/diagnostics12102406.

Automatic Quantitative Assessment of Lens Opacities Using Two Anterior Segment Imaging Techniques: Correlation with Functional and Surgical Metrics

Lars H B Mackenbrock  1 , Grzegorz Łabuz  1 , Timur M Yildirim  1 , Gerd U Auffarth  1 , Ramin Khoramnia  1
Affiliations

Automatic Quantitative Assessment of Lens Opacities Using Two Anterior Segment Imaging Techniques: Correlation with Functional and Surgical Metrics

Lars H B Mackenbrock et al. Diagnostics (Basel). .

Abstract

The purpose of this study is to quantitatively assess lens opacity, using a swept-source optical coherence tomography (SS-OCT) device for anterior segment assessment, and establish the correlation with Scheimpflug imaging, corrected distance visual acuity (CDVA) and cumulative dissipated energy (CDE). This prospective cross-sectional single-center study enrolled 51 patients (51 eyes) with crystalline lens opacity. Patients with previous ocular surgery, pathologies or general disorders affecting vision were excluded. Eyes were scanned with an SS-OCT device, and lens densitometry was automatically analyzed using a custom MATLAB script which examined lens density, nuclear density and linear density. The same analyses were performed on Scheimpflug images. Preoperative CDVA and CDE during phacoemulsification were recorded. Spearman’s (ρ) and Pearson’s (r) correlation coefficients were assessed according to data normality. Statistically significant correlations were established between SS-OCT and Scheimpflug imaging using lens analysis (ρ = 0.47, p < 0.001), nuclear analysis (ρ = 0.73, p < 0.001) and linear analysis (r = 0.44, p < 0.001). A significant correlation with CDE was found with all the SS-OCT methods (r = 0.57, p < 0.001). Only the nuclear analysis of the SS-OCT scans (Tb = −0.33, p < 0.01) and Pentacam Nucleus Staging (Tb = −0.26, p < 0.05) showed a statistically significant correlation with CDVA. Good inter-device agreement in lens densitometry was found. However, SS-OCT yielded improved lens imaging compared with the Scheimpflug device and a higher correlation with clinical parameters. Thus, high-resolution SS-OCT has the potential to become a preferable option for automatic cataract grading and preoperative planning.

Keywords: Scheimpflug imaging; anterior segment OCT; cataract.

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Conflict of interest statement

L. H. B. Mackenbrock: none; G. Łabuz: none; T. M. Yildirim: Alcon (honoraria for lecture); G. U. Auffarth: Alcon (research grant and honoraria for lecture), Heidelberg Engineering and Oculus (honoraria for lecture); R. Khoramnia: Alcon (research grant and honoraria for lecture), Heidelberg Engineering and Oculus (honoraria for lecture). The funders had no role in the design of the study; in the collection, analyses, or interpretation of data; in the writing of the manuscript; or in the decision to publish the results.

Figures

Figure 1
Figure 1
Automatic segmentation of (A) the entire lens, (B) the nucleus and (C) the anterior chamber in SS-OCT images performed by a custom MATLAB script.
Figure 2
Figure 2
Linear density analysis using SS-OCT. The graph represents the intensity values along the red line (A-Scan). Linear density is calculated through the mean of the values between the 3rd and 4th blue line.
Figure 3
Figure 3
Manual densitometric analysis of the Pentacam images using the nucleus (ROI) (A), the linear method (A) and the lens (3D) method (B).
Figure 4
Figure 4
Scatter plots of the correlations between SS-OCT and Scheimpflug imaging using the (A) lens method, (B) nucleus method and (C) linear method. (D) is the correlation between PNS and the nucleus method used on the SS-OCT scans.
Figure 5
Figure 5
Scatter plots of the correlation between (A) nuclear density in SS-OCT and CDVA, (B) nuclear density in Scheimpflug imaging and CDVA, and (C) lens density in SS-OCT and CDE without femtosecond laser use.
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