ABCD progression display for keratoconus progression: a sensitivity-specificity study

Objective To evaluate the sensitivity and specificity of the ABCD progression display for keratoconus progression. Methods Data was collected from patients that underwent at least two Pentacam assessments 6 months apart. Sensitivity and specificity were calculated for the ABCD progression display. P...

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Bibliographic Details
Published in:Eye (London) 2023-06, Vol.37 (8), p.1566-1570
Main Authors: Achiron, Asaf, Yavnieli, Roy, Tiosano, Alon, Elbaz, Uri, Nahum, Yoav, Livny, Eitan, Bahar, Irit
Format: Article
Language:English
Subjects:
692/308/409
692/699/3161/3163
Classification
Contact lenses
Cornea
Corneal Topography - methods
Decision making
Humans
Keratoconus
Keratoconus - diagnosis
Laboratory Medicine
Medicine
Medicine & Public Health
Ophthalmology
Patients
Pharmaceutical Sciences/Technology
Retrospective Studies
ROC Curve
Sensitivity analysis
Sensitivity and Specificity
Software
Surgery
Surgical Oncology
Tomography
Topography
Visual acuity
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Summary:Objective To evaluate the sensitivity and specificity of the ABCD progression display for keratoconus progression. Methods Data was collected from patients that underwent at least two Pentacam assessments 6 months apart. Sensitivity and specificity were calculated for the ABCD progression display. Progression was defined by criterion 1: change in two ABCD parameters above 80% confidence interval (CI) or criterion 2: change in one ABCD parameter above 95%CI. Receiver operating characteristic analysis compared the area under the curve (AUC) of all ABCD parameter combinations. Results Thirty eyes were evaluated over a median time of 10.3 months. Progression by criterion 1 resulted in a sensitivity of 61.9% and specificity of 88.9%. Progression by criterion 2 resulted in higher sensitivity (80.9%) and specificity (100%). Pairwise comparisons of the ROC curves show that the AUC achieved by criterion 2 was significantly higher than criterion 1 (0.905 vs. 0.754, p  = 0.0332). Evaluation of all ABCD combinations with a significant change of 80% or 95% CI did not show superiority over criterion 1 or 2 regarding progression detection. The D parameter had a very low AUC (0.5–0.556). Conclusions The ABCD progression display can assess keratoconus progression with high sensitivity and specificity, thus assisting the patients’ decision-making process. The D parameter did not contribute to the sensitivity or specificity of this classification.
ISSN:0950-222X
1476-5454
DOI:10.1038/s41433-022-02183-3