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An exploratory analysis of forme fruste keratoconus sensitivity diagnostic parameters

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Abstract

Purpose

To secondary statistical analysis of the Pentacam or Corvis ST parameters from literatures, and to obtain more sensitive diagnostic parameters for clinical keratoconus (CKC) and forme fruste keratoconus (FFKC), respectively.

Methods

The parameters and the corresponding area of ROC curve (AUC) in previous studies were extracted and screened to obtain the database of CKC (Data-CKC) and FFKC (Data-FFKC), respectively. Two different importance evaluation methods (%IncMSE and IncNodePurity) of random forest were used to preliminary select the important parameters. Then, based on the partial dependency analysis, the sensitive diagnostic parameters that had promotion to the diagnostic performance were obtained. Data-FFKC was analyzed in the same way. Finally, a diagnostic test meta-analysis on the sensitive parameter of interest was conducted to verify the reliability of the above analysis methods.

Results

There were 88 parameters with 766 records in Data-CKC, 57 parameters with 346 records in Data-FFKC. Based on two importance evaluation methods, 60 important parameters were obtained, of which 20 were further screened as sensitive parameters of keratoconus, and most of these parameters were related to the thinnest point of cornea. The stiffness parameter at first applanation (SPA1) was the only Corvis ST output parameter sensitive to FFKC except the Tomographic and Biomechanical Index and the Corvis Biomechanical Parameter (CBI). A total of 4 records were included in the meta-analysis of diagnostic tests on SPA1. The results showed that there was threshold effect, but no significant heterogeneity (I2 = 33%), and the area under the SROC curve was 0.87 (95% CI, 0.84–0.90).

Conclusions

For the diagnosis of FFKC, the sensitivity of SPA1 is not inferior to the well-known CBI, and may be the earliest Corvis ST output parameter to reflect the changes of corneal biomechanics during keratoconus progression. The elevation parameters based on the typical position of the thinnest point of corneal thickness are of great significance for the diagnosis of keratoconus.

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Data can be shared upon request.

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Acknowledgements

This study was fund by the National Natural Science Foundation of China (No. 32171304).

Funding

This work was financially supported by the National Natural Science Foundation of China (No. 32171304). The authors have no relevant financial or non-financial interest to disclose.

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Authors and Affiliations

  1. School of Biomedical Engineering, Capital Medical University, Beijing, 100069, China

    Hui Zhang, Xue Zhang, Lin Hua, Lin Li & Haixia Zhang

  2. Beijing Key Laboratory of Fundamental Research on Biomechanics in Clinical Application, Capital Medical University, Beijing, 100069, China

    Lin Hua, Lin Li & Haixia Zhang

  3. Department of Medical Engineering, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences, Beijing, 100730, China

    Hui Zhang

  4. Beijing Tongren Eye Center, Beijing Key Laboratory of Ophthalmology and Visual Sciences, Beijing Institute of Ophthalmology, Beijing Tongren Hospital, Capital Medical University, Beijing, 100730, China

    Lei Tian

  5. Beijing Advanced Innovation Center for Big Data-Based Precision Medicine, Beijing Tongren Hospital, Beihang University & Capital Medical University, Beijing, 100730, China

    Lei Tian

  6. School of Statistics, Capital University of Economics and Business, Beijing, 100070, China

    Xinxin Zhang

Authors
  1. Hui Zhang
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  2. Xue Zhang
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  3. Lin Hua
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  4. Lin Li
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  5. Lei Tian
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  7. Haixia Zhang
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Contributions

ZH, ZX independently searched and screened in the literatures, extracted the available data from eligible studies. ZH completed the whole statistical analysis and produced the first draft of the manuscript. TL provided guidance for clinical ophthalmology knowledge. HL, LL helped supervise the project and gave suggestions on revision of article. Z-XX gave some suggestions on the method of data statistical analysis. Z-HX conceived the original idea and gave critical revision of article.

Corresponding author

Correspondence to Haixia Zhang.

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Zhang, H., Zhang, X., Hua, L. et al. An exploratory analysis of forme fruste keratoconus sensitivity diagnostic parameters. Int Ophthalmol 42, 2473–2481 (2022). https://doi.org/10.1007/s10792-022-02246-0

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  • DOI: https://doi.org/10.1007/s10792-022-02246-0

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