TY - JOUR
T1 - Diagnostic Performance of Three-Dimensional Endothelium/Descemet Membrane Complex Thickness Maps in Active Corneal Graft Rejection
AU - Eleiwa, Taher K.
AU - Cook, Jane C.
AU - Elsawy, Amr S.
AU - Roongpoovapatr, Vatookarn
AU - Volante, Vincent
AU - Yoo, Sonia
AU - Abou Shousha, Mohamed
N1 - Funding Information:
Funding/Support: This study was supported by a NEI K23 award (K23EY026118), NEI core center grant to the University of Miami (P30 EY014801), and Research to Prevent Blindness (RPB). The funding organization had no role in the design or conduct of this research. Financial Disclosures: Taher Eleiwa, Jane Cook, Amr Elsawy, Vincent Volante, and Vatookarn Roongpoovapatr have no conflicts/disclosures to declare. Sonia Yoo and Mohamed Abou Shousha: United States Non-Provisional Patents (Application No. 8992023 and 61809518), and PCT/US2018/013409. Patents and PCT are owned by the University of Miami and licensed to Resolve Ophthalmics, LLC. Mohamed Abou Shousha and Sonia Yoo are equity holders and sit on the Board of Directors for Resolve Ophthalmics, LLC. Sonia H. Yoo is a consultant of Carl Zeiss. All authors attest that they meet the current ICMJE criteria for authorship. Availability of data and material: The datasets used and/or analyzed during the current study are available from the corresponding author on reasonable request.
Funding Information:
Funding/Support: This study was supported by a NEI K23 award ( K23EY026118 ), NEI core center grant to the University of Miami ( P30 EY014801 ), and Research to Prevent Blindness (RPB). The funding organization had no role in the design or conduct of this research. Financial Disclosures: Taher Eleiwa, Jane Cook, Amr Elsawy, Vincent Volante, and Vatookarn Roongpoovapatr have no conflicts/disclosures to declare. Sonia Yoo and Mohamed Abou Shousha: United States Non-Provisional Patents (Application No. 8992023 and 61809518), and PCT/US2018/013409. Patents and PCT are owned by the University of Miami and licensed to Resolve Ophthalmics, LLC. Mohamed Abou Shousha and Sonia Yoo are equity holders and sit on the Board of Directors for Resolve Ophthalmics, LLC. Sonia H. Yoo is a consultant of Carl Zeiss. All authors attest that they meet the current ICMJE criteria for authorship.
Publisher Copyright:
© 2019 Elsevier Inc.
PY - 2020/2
Y1 - 2020/2
N2 - 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.
AB - 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.
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U2 - 10.1016/j.ajo.2019.10.022
DO - 10.1016/j.ajo.2019.10.022
M3 - Article
C2 - 31678558
AN - SCOPUS:85078447288
VL - 210
SP - 48
EP - 58
JO - American Journal of Ophthalmology
JF - American Journal of Ophthalmology
SN - 0002-9394
ER -