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Zhangliang Li, Yun-e Zhao, Pingjun Chang, Yinying Zhao, Xixia Ding; Dysfunctional lens index serves as a novel surgery decision maker for age-related cataracts. Invest. Ophthalmol. Vis. Sci. 2018;59(9):4791. doi: https://doi.org/.
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© ARVO (1962-2015); The Authors (2016-present)
To study the correlations among the dysfunctional lens index (DLI), Lens Opacities Classification System III (LOCS III) nuclear opalescence grading score, preoperative corrected distance visual acuity (CDVA), the objective scatter index (OSI) and Scheimpflug based average lens density in age-related cataracts. To investigate the potential of the DLI as a novel surgery decision maker via the Receiver Operating Characteristic (ROC) curve analysis.
In this prospective cross-sectional study, a total of 59 eyes (50 patients) with age-relate cataract were recruited and divided into the Surgical and Non-Surgical groups based on the decision made by three experienced surgeons separately. The DLI, OSI, average lens density, LOCS III nuclear opalescence grading, and preoperative CDVA were obtained. Correlations among these parameters were analyzed. ROC curves were used to analyze DLI values to determine a value to separate between surgical and non-surgical cataracts.
The DLI showed the strongest correlation with the LOCS III nuclear opalescence score (r=-0.708, P< .001), compared to preoperative CDVA (r=0.364, P= .005), OSI (r=-0.552, P< .001) or average lens density (r=-0.584, P< .001). The area under curve (AUC) of OSI and DLI ROC curve was 0.871 and 0.875 (P< .001, both), respectively. With similar sensitivity (71.4%) corresponding to that of OSI criterion level of 3.3 (78.6%), a DLI cut-off value of 5.2 implied higher level of specificity (93.5%) than that of OSI criterion (81.6%).
The DLI is a valuable metric in monitoring the severity of age-related nuclear cataracts. With higher level of specificity, the surgery criterion of DLI ≤ 5.2 is more specific than the surgery criterion of OSI ≥ 3.3 in discriminating non-surgery indicated eyes from surgery indicated eyes.
This is an abstract that was submitted for the 2018 ARVO Annual Meeting, held in Honolulu, Hawaii, April 29 - May 3, 2018.
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