Taher K Eleiwa1, Jane C Cook2, Amr S Elsawy3, Vatookarn Roongpoovapatr2, Vincent Volante2, Sonia Yoo2, Mohamed Abou Shousha4. 1. Bascom Palmer Eye Institute, Miller School of Medicine, University of Miami, Miami, Florida, USA; Department of Ophthalmology, Faculty of Medicine, Benha University, Benha, Egypt. 2. Bascom Palmer Eye Institute, Miller School of Medicine, University of Miami, Miami, Florida, USA. 3. Bascom Palmer Eye Institute, Miller School of Medicine, University of Miami, Miami, Florida, USA; Department of Electrical and Computer Engineering, University of Miami, Miami, Florida, USA. 4. Bascom Palmer Eye Institute, Miller School of Medicine, University of Miami, Miami, Florida, USA; Department of Electrical and Computer Engineering, University of Miami, Miami, Florida, USA; Biomedical Engineering, University of Miami, Miami, Florida, USA. Electronic address: m.aboushousha@med.miami.edu.
Abstract
PURPOSE: To evaluate the performance of 3-dimensional (3D) endothelium/Descemet membrane complex thickness (En/DMT) maps vs total corneal thickness (TCT) maps in the diagnosis of active corneal graft rejection. DESIGN: Cross-sectional study. METHODS: Eighty-one eyes (32 clear grafts and 17 with active rejection, along with 32 age-matched control eyes) were imaged using high-definition optical coherence tomography (HD-OCT), and a custom-built segmentation algorithm was used to generate 3D color-coded maps of TCT and En/DMT of the central 6-mm cornea. Regional En/DMT and TCT were analyzed and compared between the studied groups. Receiver operating characteristic curves were used to determine the accuracy of En/DMT and TCT maps in differentiating between studied groups. Main outcome measures were regional En/DMT and TCT. RESULTS: Both regional TCT and En/DMT were significantly greater in actively rejecting grafts compared to both healthy corneas and clear grafts (P < .001). Using 3D thickness maps, central, paracentral, and peripheral En/DMT achieved 100% sensitivity and 100% specificity in diagnosing actively rejecting grafts (optimal cut-off value [OCV] of 19 μm, 24 μm, and 26 μm, respectively), vs only 82% sensitivity and 96% specificity for central TCT, OCV of 587 μm. Moreover, central, paracentral, and peripheral En/DMT correlated significantly with graft rejection severity (r = 0.972, r = 0.729, and r = 0.823, respectively; P < .001). CONCLUSION: 3D En/DMT maps can diagnose active corneal graft rejection with excellent accuracy, sensitivity, and specificity. Future longitudinal studies are required to evaluate the predictive and prognostic role of 3D En/DMT maps in corneal graft rejection.
PURPOSE: To evaluate the performance of 3-dimensional (3D) endothelium/Descemet membrane complex thickness (En/DMT) maps vs total corneal thickness (TCT) maps in the diagnosis of active corneal graft rejection. DESIGN: Cross-sectional study. METHODS: Eighty-one eyes (32 clear grafts and 17 with active rejection, along with 32 age-matched control eyes) were imaged using high-definition optical coherence tomography (HD-OCT), and a custom-built segmentation algorithm was used to generate 3D color-coded maps of TCT and En/DMT of the central 6-mm cornea. Regional En/DMT and TCT were analyzed and compared between the studied groups. Receiver operating characteristic curves were used to determine the accuracy of En/DMT and TCT maps in differentiating between studied groups. Main outcome measures were regional En/DMT and TCT. RESULTS: Both regional TCT and En/DMT were significantly greater in actively rejecting grafts compared to both healthy corneas and clear grafts (P < .001). Using 3D thickness maps, central, paracentral, and peripheral En/DMT achieved 100% sensitivity and 100% specificity in diagnosing actively rejecting grafts (optimal cut-off value [OCV] of 19 μm, 24 μm, and 26 μm, respectively), vs only 82% sensitivity and 96% specificity for central TCT, OCV of 587 μm. Moreover, central, paracentral, and peripheral En/DMT correlated significantly with graft rejection severity (r = 0.972, r = 0.729, and r = 0.823, respectively; P < .001). CONCLUSION: 3D En/DMT maps can diagnose active corneal graft rejection with excellent accuracy, sensitivity, and specificity. Future longitudinal studies are required to evaluate the predictive and prognostic role of 3D En/DMT maps in corneal graft rejection.
Authors: Orlando Özer; Mert Mestanoglu; Antonia Howaldt; Thomas Clahsen; Petra Schiller; Sebastian Siebelmann; Niklas Reinking; Claus Cursiefen; Björn Bachmann; Mario Matthaei Journal: J Clin Med Date: 2022-05-17 Impact factor: 4.964
Authors: Taher Eleiwa; Amr Elsawy; Eyup Ozcan; Collin Chase; William Feuer; Sonia H Yoo; Victor L Perez; Mohamed F Abou Shousha Journal: Sci Rep Date: 2021-07-15 Impact factor: 4.379