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Waser K, Honeder A, Hirnschall N, Khalil H, Pomberger L, Laubichler P, Mariacher S, Bolz M. "Predicting intraocular lens tilt using a machine learning concept". J Cataract Refract Surg 2024:02158034-990000000-00400. [PMID: 38529959 DOI: 10.1097/j.jcrs.0000000000001452] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/06/2023] [Accepted: 03/21/2024] [Indexed: 03/27/2024]
Abstract
OBJECTIVE Aim of this study was to use a combination of partial least squares regression and a machine learning approach to predict IOL tilt using pre-operative biometry data. SETTING Patients scheduled for cataract surgery at the Kepler University Clinic Linz. DESIGN Prospective single center study. METHODS Optical coherence tomography, autorefraction and subjective refraction was performed at baseline and 8 weeks after cataract surgery. In analysis I only one eye per patient was included and a tilt prediction model was generated. In analysis II a pair-wise comparison between right and left eyes was performed. RESULTS In analysis I 50 eyes of 50 patients were analysed. Difference in amount, orientation and vector from pre- to post-operative lens tilt was -0.13°, 2.14° and 1.20° respectively. A high predictive power (variable importance for projection) for post-operative tilt prediction was found for pre-operative tilt (VIP=2.2), pupil decentration (VIP=1.5), lens thickness (VIP=1.1), axial eye length (VIP=0.9) and pre-operative lens decentration (VIP=0.8). These variables were applied to a machine learning algorithm resulting in an out of bag score of 0.92°. In analysis II 76 eyes of 38 patients were included. The difference of pre- to post-operative IOL tilt of right and left eyes of the same individuum was statistically relevant. CONCLUSION Post-operative IOL tilt showed excellent predictability using pre-operative biometry data and a combination of partial least squares regression and a machine learning algorithm. Pre-operative lens tilt, pupil decentration, lens thickness, axial eye length and pre-operative lens decentration were found to be the most relevant parameters for this prediction model.
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Affiliation(s)
- Klemens Waser
- Kepler University Clinic Linz, Austria
- Johannes Kepler University Linz, Austria
| | - Andreas Honeder
- Kepler University Clinic Linz, Austria
- Johannes Kepler University Linz, Austria
| | - Nino Hirnschall
- Kepler University Clinic Linz, Austria
- Johannes Kepler University Linz, Austria
| | - Haidar Khalil
- Kepler University Clinic Linz, Austria
- Johannes Kepler University Linz, Austria
| | - Leon Pomberger
- Kepler University Clinic Linz, Austria
- Johannes Kepler University Linz, Austria
| | - Peter Laubichler
- Kepler University Clinic Linz, Austria
- Johannes Kepler University Linz, Austria
| | - Siegfried Mariacher
- Kepler University Clinic Linz, Austria
- Johannes Kepler University Linz, Austria
| | - Matthias Bolz
- Kepler University Clinic Linz, Austria
- Johannes Kepler University Linz, Austria
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Pomberger L, Tasch L, Lundström M, Waser K, Khalil H, Kronschläger M, Hirnschall N, Bolz M. Evaluation of the German Version of the Keratoconus Outcomes Research Questionnaire. Cornea 2024:00003226-990000000-00492. [PMID: 38381057 DOI: 10.1097/ico.0000000000003506] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/25/2023] [Accepted: 01/07/2024] [Indexed: 02/22/2024]
Abstract
PURPOSE To translate, validate, and evaluate the psychometric properties of the German version of Keratoconus Outcomes Research Questionnaire (KORQ). METHODS This prospective study included 3 phases. In phase 1, the KORQ was translated in a standardized way; in phase 2, Rasch validation was performed; in phase 3, the validated questionnaire was evaluated in a separate patient cohort. All patients answered the German KORQ. Scheimpflug imaging (Pentacam) and optical coherence tomography scans (MS-39) were conducted. Corneal imaging measurements were correlated with patient-reported outcome measures. RESULTS After standardized translation, 100 patients self-administered the German KORQ. Rasch analysis was conducted for psychometric testing of the KORQ. Based on the results of the Rasch analysis, the original German version of the KORQ was modified and any items showing a misfit were excluded. This resulted in a new shortened version of the KORQ, which was evaluated in 30 patients. The revised German KORQ met the criteria of Rasch analysis and showed excellent internal consistency reliability and convergent validity. The correlation between the KORQ score and various clinical measurements was examined using Spearman correlation. A significant moderate correlation was observed between the D (r = 0.237; P = 0.006) and Kmax (r = 0.162; P = 0.065) values of Pentacam. Inverse correlations were observed for thinnest pachymetry measured with MS-39 (r = -0.167; P = 0.058) and best corrected visual acuity (r = -0.210; P = 0.016). CONCLUSIONS The shortened German KORQ met the assumptions of the Rasch model and displayed satisfactory psychometric properties. The German KORQ could be adopted as a powerful patient-reported outcome measures tool for German-speaking patients with keratoconus in the future.
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Affiliation(s)
- Leon Pomberger
- Department of Ophthalmology, Kepler University Clinic, Linz, Austria
- Department of Ophthalmology, Johannes Kepler University, Linz, Austria
| | - Lisa Tasch
- Department of Ophthalmology, Kepler University Clinic, Linz, Austria
- Department of Ophthalmology, Johannes Kepler University, Linz, Austria
| | - Mats Lundström
- Department of Ophthalmology, Lund University, Lund, Sweden; and
| | - Klemens Waser
- Department of Ophthalmology, Kepler University Clinic, Linz, Austria
- Department of Ophthalmology, Johannes Kepler University, Linz, Austria
| | - Haidar Khalil
- Department of Ophthalmology, Kepler University Clinic, Linz, Austria
- Department of Ophthalmology, Johannes Kepler University, Linz, Austria
| | | | - Nino Hirnschall
- Department of Ophthalmology, Kepler University Clinic, Linz, Austria
- Department of Ophthalmology, Johannes Kepler University, Linz, Austria
| | - Matthias Bolz
- Department of Ophthalmology, Kepler University Clinic, Linz, Austria
- Department of Ophthalmology, Johannes Kepler University, Linz, Austria
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Khalil H, Bolz M, Waser K, Pomberger L, Laubichler P, Jirak P, Hirnschall N. Diagnostic Potential of Anterior Segment Optical Coherence Tomography Scans for Pseudomonas Keratitis. Transl Vis Sci Technol 2023; 12:34. [PMID: 38019500 PMCID: PMC10691401 DOI: 10.1167/tvst.12.11.34] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/12/2023] [Accepted: 10/09/2023] [Indexed: 11/30/2023] Open
Abstract
Purpose The purpose of this study was to investigate the diagnostic value of anterior segment optical coherence tomography (AS-OCT) scans for Pseudomonas keratitis. Methods Patients with treatment-naïve keratitis underwent AS-OCT imaging. The following parameters were evaluated: corneal thickness (CT), infiltrate thickness (IT), infiltrate diameter (ID), tissue loss/gain, entropy, and distance of the lesion from the corneal pupillary center. Three different OCT devices were used for the analysis. The relationship between the detected pathogen and the OCT patterns was analyzed. Results Nineteen eyes of 19 patients were included in the analysis: seven cases in the Pseudomonas group and 12 cases in the Gram-positive group. The mean (SD) values for the Pseudomonas and Gram-positive groups, respectively, were as follows: CT, 834 µm (165 µm) and 760 µm (120 µm); IT, 290 µm (152 µm) and 287 µm (84 µm); ID, 2067 µm (1470 µm) and 1307 µm (745 µm); distance to center, 3.0 mm (1.2 mm) and 3.0 mm (1.6 mm); epithelial defect, 1193 µm (586 µm) and 484 µm (615 µm); tissue gain, +31% (19%) and +10% (12%); and entropy level, 4.0 (0.8) and 3.9 (1.1). Conclusions This study introduces novel insights by identifying specific OCT parameters that distinguish Pseudomonas keratitis, including a 30% tissue gain. These findings align with earlier research that underscores the potential of OCT in differentiating various pathogens causing keratitis. Translational Relevance The findings of this study could be used to develop new diagnostic strategies for Pseudomonas keratitis. The OCT findings could be used to develop new biomarkers for the infection.
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Affiliation(s)
- Haidar Khalil
- Department of Ophthalmology and Optometry, Kepler University Clinic GmbH, Johannes Kepler University, Linz, Austria
- Medical Faculty, Johannes Kepler University, Linz, Austria
| | - Matthias Bolz
- Department of Ophthalmology and Optometry, Kepler University Clinic GmbH, Johannes Kepler University, Linz, Austria
- Medical Faculty, Johannes Kepler University, Linz, Austria
| | - Klemens Waser
- Department of Ophthalmology and Optometry, Kepler University Clinic GmbH, Johannes Kepler University, Linz, Austria
- Medical Faculty, Johannes Kepler University, Linz, Austria
| | - Leon Pomberger
- Department of Ophthalmology and Optometry, Kepler University Clinic GmbH, Johannes Kepler University, Linz, Austria
- Medical Faculty, Johannes Kepler University, Linz, Austria
| | - Peter Laubichler
- Department of Ophthalmology and Optometry, Kepler University Clinic GmbH, Johannes Kepler University, Linz, Austria
- Medical Faculty, Johannes Kepler University, Linz, Austria
| | - Paul Jirak
- Department of Ophthalmology and Optometry, Kepler University Clinic GmbH, Johannes Kepler University, Linz, Austria
| | - Nino Hirnschall
- Department of Ophthalmology and Optometry, Kepler University Clinic GmbH, Johannes Kepler University, Linz, Austria
- Medical Faculty, Johannes Kepler University, Linz, Austria
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Mursch-Edlmayr A, Pickl L, Calzetti G, Waser K, Wendelstein J, Beka S, Aranha dos Santos V, Luft N, Schmetterer L, Bolz M. Comparison of Neurovascular Coupling between Normal Tension Glaucoma Patients and Healthy Individuals with Laser Speckle Flowgraphy. Curr Eye Res 2020; 45:1438-1442. [DOI: 10.1080/02713683.2020.1752390] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
Affiliation(s)
- A.S. Mursch-Edlmayr
- Department for Ophthalmology, Kepler University Hospital GmbH, Johannes Kepler University Linz, Linz, Austria
| | - L. Pickl
- Johannes Kepler University, Linz, Austria
| | - G. Calzetti
- Ophthalmology Unit, University Hospital of Parma, Parma, Italy
| | - K. Waser
- Department for Ophthalmology, Kepler University Hospital GmbH, Johannes Kepler University Linz, Linz, Austria
| | - J. Wendelstein
- Department for Ophthalmology, Kepler University Hospital GmbH, Johannes Kepler University Linz, Linz, Austria
| | - S. Beka
- Department for Ophthalmology, Kepler University Hospital GmbH, Johannes Kepler University Linz, Linz, Austria
| | - V. Aranha dos Santos
- Center for Medical Physics and Biomedical Engineering, Medical University of Vienna, Vienna, Austria
| | - N. Luft
- Department for Ophthalmology, University Eye Hospital, Ludwig-Maximilians-University, Munich, Germany
| | - L. Schmetterer
- Center for Medical Physics and Biomedical Engineering, Medical University of Vienna, Vienna, Austria
- Singapore Eye Research Institute, Singapore National Eye Centre, Singapore
- School of Chemical and Biomedical Engineering, Nanyang Technological University, Singapore
- Ophthalmology and Visual Sciences Academic Clinical Program, Duke-NUS Medical School, Singapore
- SERI-NTU Advanced Ocular Engineering (STANCE), Singapore, Singapore
| | - M. Bolz
- Department for Ophthalmology, Kepler University Hospital GmbH, Johannes Kepler University Linz, Linz, Austria
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Mursch-Edlmayr AS, Waser K, Podkowinski D, Bolz M. Differences in swept-source OCT angiography of the macular capillary network in high tension and normal tension glaucoma. Curr Eye Res 2020; 45:1168-1172. [PMID: 32011184 DOI: 10.1080/02713683.2020.1722178] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
Abstract
AIM OF THE STUDY The purpose of the present study was to determine if swept-source optical coherence tomography angiography (OCTA) of the superficial plexus in the macular region can detect differences between high-tension open-angle glaucoma (HTG) and normal-tension glaucoma (NTG). MATERIALS AND METHODS In this prospective study 60 eyes from 60 patients (40 HTG; 20 NTG) underwent fovea centred 3 × 3 mm cube macula OCTA imaging by a swept-source OCTA device (Plex Elite, Zeiss, Jena, Germany). Quantitative analysis of the vasculature at the superficial plexus was performed by assessing the Perfusion Density (PD), defined as the total area of perfused vasculature per unit area in a region of measurement, for each group, respectively. Besides, macular ganglion cell layer thickness and mean deviation from visual field testing was assessed and correlated with PD. RESULTS Average superficial PD of the measured 3 × 3 mm field was comparable between HTG and NTG (P = .567). In both groups a significant relation of PD and age (HTG: r = -0.48, p = .002; NTG: r = -0.615; p = .004) was shown, indicating reduced PD with increasing age. For both groups a positive correlation between PD and mean deviation (MD) (HTG: r = 0.492, p = .003; NTG: r = 0.530, p = .029) as well as PD and GCL thickness was shown (r = 0.486, p = .002 vs. r = 0.389; p = .09). However, the latter did not reach statistical significance in the NTG group. CONCLUSION PD at the central 3 mm around the fovea is comparable between HTG and NTG. Significant correlation with age and MD was shown in both groups.
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Affiliation(s)
- Anna Sophie Mursch-Edlmayr
- Department of Ophthalmology, Johannes Kepler University Linz, Kepler University Hospital GmBh , Linz, Austria
| | - Klemens Waser
- Department of Ophthalmology, Johannes Kepler University Linz, Kepler University Hospital GmBh , Linz, Austria
| | - Dominika Podkowinski
- Department of Ophthalmology, Johannes Kepler University Linz, Kepler University Hospital GmBh , Linz, Austria
| | - Matthias Bolz
- Department of Ophthalmology, Johannes Kepler University Linz, Kepler University Hospital GmBh , Linz, Austria
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