Detection of Keratoconus With a New Corvis Biomechanical Index Optimized for Chinese Populations

Riccardo Vinciguerra; Renato Ambrosio; Yan Wang; Fengju Zhang; Xingtao Zhou; Ji Bai; Keming Yu; Shihao Chen; Xuejun Fang; Paolo Vinciguerra

doi:10.1016/j.ajo.2023.04.002

Detection of Keratoconus With a New Corvis Biomechanical Index Optimized for Chinese Populations

Am J Ophthalmol. 2023 Aug:252:182-187. doi: 10.1016/j.ajo.2023.04.002. Epub 2023 Apr 13.

Authors

Riccardo Vinciguerra¹, Renato Ambrosio², Yan Wang³, Fengju Zhang⁴, Xingtao Zhou⁵, Ji Bai⁶, Keming Yu⁷, Shihao Chen⁸, Xuejun Fang⁹, Paolo Vinciguerra¹⁰

Affiliations

¹ From Humanitas San Pio X Hospital (R.V.), Milan, Italy. Electronic address: vinciguerra.riccardo@gmail.com.
² Department of Ophthalmology (R.A.), the Federal University of the State of Rio de Janeiro, Rio de Janeiro, Brazil.
³ Tianjin Eye Hospital (Y.W.), Tianjin Key Laboratory of Ophthalmology and Visual Science, Nankai University Affiliated Eye Hospital; Clinical College of Ophthalmology (Y.W.), Tianjin Medical University, Tianjin, China.
⁴ Beijing Tongren Eye Center (F.Z.), Beijing Tongren Hospital, Beijing Ophthalmology and Visual Sciences Key Lab, Capital Medical University, Beijing, China.
⁵ Eye and ENT Hospital of Fudan University (X.Z.), Shanghai, China.
⁶ BAI JI Ophthalmology (J.B.), Chongqing, China.
⁷ Zhongshan Ophthalmic Center (K.Y.), Sun Yat-Sen University, Guangzhou, China.
⁸ Eye Hospital (S.C.), Wenzhou Medical University, Zhejiang, China.
⁹ Shenyang Aier Eye Hospital (X.F.), Shenyang, China.
¹⁰ Humanitas University, Department of Biomedical Sciences, Via Rita Levi Montalcini 4, 20090 Pieve Emanuele, Milan, Italy; IRCCS Humanitas Research Hospital, via Manzoni 56, 20089 Rozzano, Milan, Italy.

PMID: 37059320
DOI: 10.1016/j.ajo.2023.04.002

Abstract

Purpose: The aim of this study was to introduce an optimized version of the Corvis Biomechanical Index for Chinese populations (cCBI).

Design: Retrospective, multicenter clinical validity enhancement study.

Methods: Patients were included from 7 clinics in Beijing, Shenyang, Guangzhou, Shanghai, Wenzhou, Chongqing, and Tianjin, China. Logistic regression was used to optimize the values of the constants of the CBI, based on database 1 as the development dataset (6 of 7 clinics), to create a new version of the index named cCBI. The factors of the CBI (A1Velocity, ARTh, Stiffness Parameter-A, DARatio2mm, and Inverse Integrated Radius) and the cutoff value were kept the same (0.5). With the formation of cCBI determined, it was validated on database 2 (1 of the 7 clinics).

Results: Two thousand four hundred seventy-three patients (healthy and keratoconus) were included. In database 2, the area under the curve of the cCBI was 0.985 with 93.4% specificity and 95.5% sensitivity. In the same dataset, the original CBI produced an area under the curve of 0.978 with 68.1% specificity and 97.7% sensitivity. There was a statistically significant difference between the receiver operating characteristic curve of cCBI and CBI (De Long P = .0009) CONCLUSION: The new cCBI for Chinese patients was shown to be statistically significantly better when compared with CBI to separate healthy from keratoconic eyes. The presence of an external validation dataset confirms this finding and suggests the use of cCBI in everyday clinical practice to aid in the diagnosis of keratoconus in patients who are of Chinese ethnicity.

Publication types

Multicenter Study

MeSH terms

Biomechanical Phenomena
China / epidemiology
Cornea
Corneal Topography
East Asian People
Humans
Keratoconus* / diagnosis
Keratoconus* / epidemiology
ROC Curve
Retrospective Studies