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Lens nuclear opacity quantitation with long-range swept-source optical coherence tomography: correlation to LOCS III and a Scheimpflug imaging-based grading system
  1. Ding Chen1,
  2. Zhangliang Li1,2,3,
  3. Jinhai Huang1,2,3,
  4. Liuqing Yu1,4,
  5. Songjia Liu1,2,3,
  6. Yun-e Zhao1,2,3
  1. 1 School of Ophthalmology and Optometry, Wenzhou Medical University, Wenzhou, China
  2. 2 Department of Ophthalmology, Eye Hospital of Wenzhou Medical University, Wenzhou, China
  3. 3 Key Laboratory of Vision Science, Ministry of Health P.R. China, Wenzhou, China
  4. 4 Department of Ophthalmology, The First People's Hospital of Fuyang Hangzhou, Hangzhou, Zhejiang, China
  1. Correspondence to Dr Yun-e Zhao, Eye Hospital of Wenzhou Medical University, Wenzhou, Zhejiang 325027, China; zye{at}
  • Present affiliation The present affiliation of Liuqing Yu is: Department of Ophthalmology, The First People's Hospital of Fuyang Hangzhou, Hangzhou, Zhejiang, China


Purpose To quantitate lens nuclear opacity using long-range swept-source optical coherence tomography (SS-OCT) images and to evaluate the correlation of this method to Lens Opacities Classification System III (LOCS III) and a Scheimpflug imaging-based grading system (Pentacam Nuclear Stage function; PNS).

Methods This study enrolled 120 participants (120 eyes) with age-related nuclear cataracts. The best-corrected visual acuity (BCVA), LOCS III nuclear opalescence (NO) and nuclear colour (NC) were obtained. The nuclear density measured using PNS function (NDPNS) was recorded. Three successive series of long-range SS-OCT images were captured, and the nuclear region was analysed using ImageJ (NIH, Bethesda, Maryland, USA) to generate SS-OCT image-based nuclear density (NDSS-OCT). The repeatability of NDSS-OCT measurement was evaluated using within-subject coefficient of variation (CVw) and intraclass correlation coefficient (ICC). Correlations of NDSS-OCT with NO and NC, BCVA and NDPNS were analysed. According to the integrity of nucleus imaged by Pentacam, patients were divided into two groups, and the parameters were compared between groups.

Results The CVw and ICC for NDSS-OCT measurement were 1.5 % and 0.994, respectively. The NDSS-OCT significantly correlated with NO (r=0.831), NC (r=0.873), BCVA (r=0.655) and NDPNS (r=0.891). The NDSS-OCT, NO and NC, and BCVA were significantly different between the two groups.

Conclusion Lens nuclear opacity quantitation using long-range SS-OCT images was repeatable and correlated well with LOCS III and PNS function. The Scheimpflug principle had a limitation in imaging dense nucleus. Long-range SS-OCT seems more promising for objectively and quantitatively assessing lens nuclear opacity.

  • lens and zonules
  • imaging

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  • DC and ZL are joint first authors.

  • Contributors DC involved in conception of the study; DC, ZL and YZ: design of the study; DC and ZL: conduct of the study; DC, ZL, LY and SL: collection of the data; DC, ZL and JH: analysis of the data; DC and ZL: preparation of the manuscript; YZ: provision of the materials and resources; all authors: review and approval of the manuscript.

  • Funding This work was supported by Zhejiang Province Key Research and Development Program (grant number 2018C03012) and the Innovation Discipline of Zhejiang Province (grant number 2016cxxk1).

  • Competing interests None declared.

  • Patient consent Obtained.

  • Provenance and peer review Not commissioned; externally peer reviewed.

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