Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2024 Dec 1;50(12):1247-1253.
doi: 10.1097/j.jcrs.0000000000001542.

Forme fruste keratoconus detection with OCT corneal topography using artificial intelligence algorithms

Eugénie Mourgues  1 , Virgile Saunier, David Smadja, David Touboul, Valentine Saunier
Affiliations

Forme fruste keratoconus detection with OCT corneal topography using artificial intelligence algorithms

Eugénie Mourgues et al. J Cataract Refract Surg. .

Abstract

Purpose: To differentiate a normal cornea from a forme fruste keratoconus (FFKC) with the swept-source optical coherence tomography (SS-OCT) topography CASIA 2 using machine learning artificial intelligence algorithms.

Setting: Monocentric, performed in CHU Bordeaux, Bordeaux, France.

Design: Retrospective case-control.

Methods: 3 groups were included: KC group (108 eyes), FFKC (88 eyes), and normal corneas (162 eyes). The data were analyzed and processed using the Dataiku data science platform. Machine learning models (random forest [RF], logistic regression [LR]) were used to develop a multiclass classifier for automated early KC detection. The models were trained using a training database and tested using a test database. Then, algorithms were compared with the Ectasia Screening Index (ESI), which is an OCT-topography inherent screening score for ectasia.

Results: The LR and RF detected FFKC with an area under the curve of 0.99 and 0.98, respectively. The sensitivities of LR (100%) and RF (84%) were better than the ESI (28%) for the diagnosis of FFKC. However, ESI has a maximum specificity (100%) compared with the LR (100%) and 90% for RF.

Conclusions: This study identified discriminating topographic parameters to be considered in refractive surgery screening on SS-OCT CASIA 2. An algorithm capable of classifying normal eyes vs FFKC cases was developed, with improved performance compared with the ESI score.

PubMed Disclaimer

Figures

Figure 1.
Figure 1.
The yellow square shows the parameters used in logistic regression and random forest for the diagnosis of FFKC. FFKC = forme fruste keratoconus
Figure 2.
Figure 2.
The histogram represents the data selected by the random forest algorithm and their importance in distinguishing FFKC from a healthy eye. The most discriminating data are grouped in this figure. Aberr Ant = aberration anterior; Aberr Post = aberration posterior; CTP = corneal thinnest point; EPHy = elevation posterior highest offset y in millimeters; FFKC = forme fruste keratoconus; FIAP AP 6 = Fourier index axial power asymmetry posterior within 6 mm; IPI Y = instantaneous posterior offset set Y in millimeters; Pachy T = pachymetry temporal
See this image and copyright information in PMC

References

    1. Krachmer JH, Feder RS, Belin MW. Keratoconus and related noninflammatory corneal thinning disorders. Surv Ophthalmol. 1984;28(4):293–322. doi:10.1016/0039-6257(84)90094-8 - DOI - PubMed
    1. Saunier V, Mercier AE, Gaboriau T, Malet F, Colin J, Fournié P, Malecaze F, Touboul D. Vision-related quality of life and dependency in French keratoconus patients: impact study. J Cataract Refract Surg. 2017;43(12):1582–1590. doi:10.1016/j.jcrs.2017.08.024 - DOI - PubMed
    1. Tatar MG, Aylin Kantarci F, Yildirim A, Uslu H, Colak HN, Goker H, Gurler B. Risk factors in post-LASIK corneal ectasia. J Ophthalmol. 2014;2014:204191. doi:10.1155/2014/204191 - DOI - PMC - PubMed
    1. Seiler T, Quurke AW. Iatrogenic keratectasia after LASIK in a case of forme fruste keratoconus. J Cataract Refract Surg. 1998;24(7):1007–1009. doi:10.1016/S0886-3350(98)80057-6 - DOI - PubMed
    1. Sahay P, Bafna R, Reddy J, Vajpayee R, Sharma N. Complications of laser-assisted in situ keratomileusis. Indian J Ophthalmol. 2021;69(7):1658–1669. doi:10.4103/ijo.IJO_1872_20 - DOI - PMC - PubMed

LinkOut - more resources