PT  - JOURNAL ARTICLE
AU  - Wang, Wei
AU  - Zhang, Jiaqing
AU  - Gu, Xiaoxun
AU  - Ruan, Xiaoting
AU  - Chen, Xiaoyun
AU  - Tan, Xuhua
AU  - Jin, Guangming
AU  - Wang, Lanhua
AU  - He, Mingguang
AU  - Congdon, Nathan
AU  - Liu, Zhenzhen
AU  - Luo, Lixia
AU  - Liu, Yizhi
TI  - Objective quantification of lens nuclear opacities using swept-source anterior segment optical coherence tomography
AID  - 10.1136/bjophthalmol-2020-318334
DP  - 2022 Jun 01
TA  - British Journal of Ophthalmology
PG  - 790--794
VI  - 106
IP  - 6
4099  - http://bjo.bmj.com/content/106/6/790.short
4100  - http://bjo.bmj.com/content/106/6/790.full
SO  - Br J Ophthalmol2022 Jun 01; 106
AB  - Background/aims The primary objective is to quantify the lens nuclear opacity using swept-source anterior segment optical coherence tomography (SS-ASOCT) and to evaluate its correlations with Lens Opacities Classification System III (LOCS-III) system and surgical parameters. The secondary objective is to assess the diagnostic performance for hard nuclear cataract.Methods This cross-sectional study included 1222 patients eligible for cataract surgery (1222 eyes). The latest SS-ASOCT (CASIA-2) was used to obtain high-resolution lens images, and the average nuclear density (AND) and maximum nuclear density (MND) were measured by a custom ImageJ software. Spearman’s correlations analysis was used to assess associations of AND/MND with LOCS-III nuclear scores, visual acuity and surgical parameters. The subjects were then split randomly (9:1) into the training dataset and validating dataset. Receiver operating characteristic curves and calibration curves were constructed for the classification on hard nuclear cataract.Results The AND and MND from SS-ASOCT images were significantly correlated with nuclear colour scores (AND: r=0.716; MND: r=0.660; p<0.001) and nuclear opalescence scores (AND: r=0.712; MND: r=0.655; p<0.001). The AND by SS-ASOCT images had the highest values of Spearman’s r for preoperative corrected distance visual acuity (r=0.3131), total ultrasonic time (r=0.3481) and cumulative dissipated energy (r=0.4265). The nuclear density had good performance in classifying hard nuclear cataract, with area under the curves of 0.859 (0.831–0.886) for AND and 0.796 (0.768–0.823) for MND.Conclusion Objective and quantitative evaluation of the lens nuclear density using SS-ASOCT images enable accurate diagnosis of hard nuclear cataract.All data relevant to the study are included in the article or uploaded as supplemental information.