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M. Saika, T. Nakagawa, Y. Kitaguchi, Y. Hirohara, T. Mihashi, N. Maeda, T. Fujikado; Cut-Off Values in Root Mean Square(rms) of Ocular Higher-Order Aberrations for Differentiating Normal Eyes From Pathological Conditions. Invest. Ophthalmol. Vis. Sci. 2010;51(13):3967.
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To define the cut-off values of wavefront aberrations by comparing in normal eyes with keratoconic suspect, LASIK, or cataractous eyes.
Wavefront sensing was performed in 65 normal eyes (N), 46 keratoconic suspect eyes (KCS), 50 LASIK eyes (L) and 111 cataractous eyes (CAT) with a Shack-Hartmann aberrometer (KR-9000PW, Topcon). The ocular wavefront aberrations were analyzed with normalized Zernike polynomials up to 4th order for 4-mm diameter circular area and with normalized Zernike polynomials up to 6th order for 6-mm. Means and standard deviations (SD) were calculated with RMS of total high-order aberrations (TH-RMS). In each category, the receiver operating characteristic (ROC) between normal and the category was analyzed. Cut-off values of the RMS were determined with both sensitivity and the specificity.
TH-RMSs for each category were 0.09±0.03(mean±SD) µm (N), 0.36±0.26 µm (KCS), 0.19±0.07µm (L), and 0.27±0.14µm (CAT) for 4-mm diameter, and 0.30±0.11 µm (N), 1.05±0.65 µm (KCS), 0.74±0.24 µm (L), and 0.74±0.33 µm (CAT) for 6-mm diameter. The mean of TH-RMS for the normal eye was in agreement with previous studies(Howland, 2002). The ROC analysis showed the cut-off values of N to KCS, to L, and to CAT with 4mm TH-RMS (area under ROC curve) were 0.13 µm (0.928), 0.13 µm (0.909), and 0.15 µm (0.957) respectively. The cut-off of 6mm TH-RMS were 0.43 µm (0.908), 0.49 µm (0.987), and 0.45 µm (0.954).
We determined the cut-off value from the average of three ROC results. The cut-off value of TH-RMS was 0.14 µm in 4-mm pupil and 0.46 µm in 6-mm pupil. If we suppose the distribution of TH-RMS of normal eyes is Gaussian , 95%( mean±1.96SD) of the normal eyes lie between 0.03 to 0.15 for 4-mm diameter and 0.08 to 0.52 for 6-mm diameter. This is consistent with the cut-off values we obtained in this study.
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