Development and validation of the VAE-NT index: a novel biomechanical parameter for distinguishing subclinical corneal abnormalities
PurposeThe aim of this study is to develop an index for distinguishing between very asymmetric ectasia with normal topography (VAE-NT) eyes and normal eyes, with good performance in validity, reliability, and predictive values.MethodsIn the training dataset, this single-center retrospective study in...
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Frontiers Media S.A.
2025-07-01
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| Series: | Frontiers in Bioengineering and Biotechnology |
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| Online Access: | https://www.frontiersin.org/articles/10.3389/fbioe.2025.1598546/full |
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| author | Lanting Yang Lanting Yang Lanting Yang Hui Xu Hui Xu Honghu Jiang Jingyin Zhu Shihao Chen Shihao Chen |
| author_facet | Lanting Yang Lanting Yang Lanting Yang Hui Xu Hui Xu Honghu Jiang Jingyin Zhu Shihao Chen Shihao Chen |
| author_sort | Lanting Yang |
| collection | DOAJ |
| description | PurposeThe aim of this study is to develop an index for distinguishing between very asymmetric ectasia with normal topography (VAE-NT) eyes and normal eyes, with good performance in validity, reliability, and predictive values.MethodsIn the training dataset, this single-center retrospective study involved 102 healthy eyes and 97 VAE-NT eyes. After propensity score matching (PSM), data from 53 healthy eyes and 53 VAE-NT eyes, including demographic and Corvis ST examination results, were collected. The area under the receiver operating characteristic curve (AUC), sensitivity, specificity, intraclass correlation coefficient (ICC), and positive and negative likelihood ratios were calculated for the dynamic corneal response (DCR) parameters of Corvis ST. The Technique for Order of Preference by Similarity to Ideal Solution (TOPSIS) model was used to objectively and comprehensively evaluate the Corvis ST DCRs, and logistic regression was used to determine the optimal combination of parameters that can accurately separate VAE-NT from normal corneas. In the validation dataset, 44 VAE-NT eyes and 49 normal eyes were involved. The validity, reliability, and predictive value of the index were further assessed using the validation dataset. The VAE-NT index was compared with the tomographic and biomechanical index (TBI) in both the training and validation datasets.ResultsIn the training dataset, the optimal parameter combination forming the VAE-NT index included the following DCRs: SP A1, SP HC, A1 Time, DA Ratio Max (2 mm), DA Ratio Max (1 mm), Integrated Radius, and stress–strain index version 2 (SSI2). The receiver operating characteristic (ROC) curve analysis showed an AUC value of 0.971, with a cut-off value of 0.425, an accuracy of 95.283%, a specificity of 94.340%, and a sensitivity of 96.230%. In the validation dataset, the AUC value of the VAE-NT index was 0.980. The sensitivity and specificity of the VAE-NT index were 93.180% and 95.920%, respectively. The positive and negative likelihood ratios of the VAE-NT index were 22.830 and 0.071, respectively. The ICC of the VAE-NT index was 0.835, and the accuracy was 94.624%. The VAE-NT index outperformed TBI in both the training and validation datasets.ConclusionThe VAE-NT index was developed, exhibiting high sensitivity, specificity, and AUC, along with favorable likelihood ratios and repeatability, suggesting that the VAE-NT index is a robust and reliable tool for distinguishing VAE-NT eyes from normal eyes. Further validation in broader populations and over longer follow-up periods is needed to support clinical translation. |
| format | Article |
| id | doaj-art-da8c82eff4a944ff9dece30a280a0623 |
| institution | Kabale University |
| issn | 2296-4185 |
| language | English |
| publishDate | 2025-07-01 |
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| spelling | doaj-art-da8c82eff4a944ff9dece30a280a06232025-08-20T03:50:49ZengFrontiers Media S.A.Frontiers in Bioengineering and Biotechnology2296-41852025-07-011310.3389/fbioe.2025.15985461598546Development and validation of the VAE-NT index: a novel biomechanical parameter for distinguishing subclinical corneal abnormalitiesLanting Yang0Lanting Yang1Lanting Yang2Hui Xu3Hui Xu4Honghu Jiang5Jingyin Zhu6Shihao Chen7Shihao Chen8Department of Ophthalmology, Huadong Hospital, Fudan Universiry, Shanghai, ChinaNational Engineering Research Center of Ophthalmology and Optometry, Eye Hospital, Wenzhou Medical University, Wenzhou, ChinaNational Clinical Research Center for Ocular Diseases, Eye Hospital, Wenzhou Medical University, Wenzhou, ChinaNational Engineering Research Center of Ophthalmology and Optometry, Eye Hospital, Wenzhou Medical University, Wenzhou, ChinaNational Clinical Research Center for Ocular Diseases, Eye Hospital, Wenzhou Medical University, Wenzhou, ChinaDepartment of Ophthalmology, Huadong Hospital, Fudan Universiry, Shanghai, ChinaDepartment of Ophthalmology, Huadong Hospital, Fudan Universiry, Shanghai, ChinaNational Engineering Research Center of Ophthalmology and Optometry, Eye Hospital, Wenzhou Medical University, Wenzhou, ChinaNational Clinical Research Center for Ocular Diseases, Eye Hospital, Wenzhou Medical University, Wenzhou, ChinaPurposeThe aim of this study is to develop an index for distinguishing between very asymmetric ectasia with normal topography (VAE-NT) eyes and normal eyes, with good performance in validity, reliability, and predictive values.MethodsIn the training dataset, this single-center retrospective study involved 102 healthy eyes and 97 VAE-NT eyes. After propensity score matching (PSM), data from 53 healthy eyes and 53 VAE-NT eyes, including demographic and Corvis ST examination results, were collected. The area under the receiver operating characteristic curve (AUC), sensitivity, specificity, intraclass correlation coefficient (ICC), and positive and negative likelihood ratios were calculated for the dynamic corneal response (DCR) parameters of Corvis ST. The Technique for Order of Preference by Similarity to Ideal Solution (TOPSIS) model was used to objectively and comprehensively evaluate the Corvis ST DCRs, and logistic regression was used to determine the optimal combination of parameters that can accurately separate VAE-NT from normal corneas. In the validation dataset, 44 VAE-NT eyes and 49 normal eyes were involved. The validity, reliability, and predictive value of the index were further assessed using the validation dataset. The VAE-NT index was compared with the tomographic and biomechanical index (TBI) in both the training and validation datasets.ResultsIn the training dataset, the optimal parameter combination forming the VAE-NT index included the following DCRs: SP A1, SP HC, A1 Time, DA Ratio Max (2 mm), DA Ratio Max (1 mm), Integrated Radius, and stress–strain index version 2 (SSI2). The receiver operating characteristic (ROC) curve analysis showed an AUC value of 0.971, with a cut-off value of 0.425, an accuracy of 95.283%, a specificity of 94.340%, and a sensitivity of 96.230%. In the validation dataset, the AUC value of the VAE-NT index was 0.980. The sensitivity and specificity of the VAE-NT index were 93.180% and 95.920%, respectively. The positive and negative likelihood ratios of the VAE-NT index were 22.830 and 0.071, respectively. The ICC of the VAE-NT index was 0.835, and the accuracy was 94.624%. The VAE-NT index outperformed TBI in both the training and validation datasets.ConclusionThe VAE-NT index was developed, exhibiting high sensitivity, specificity, and AUC, along with favorable likelihood ratios and repeatability, suggesting that the VAE-NT index is a robust and reliable tool for distinguishing VAE-NT eyes from normal eyes. Further validation in broader populations and over longer follow-up periods is needed to support clinical translation.https://www.frontiersin.org/articles/10.3389/fbioe.2025.1598546/fullvery asymmetric ectasia with normal tomographydynamic corneal response parameterstechnique for order of preference by similarity to ideal solutionkeratoconuscorneal biomechanics |
| spellingShingle | Lanting Yang Lanting Yang Lanting Yang Hui Xu Hui Xu Honghu Jiang Jingyin Zhu Shihao Chen Shihao Chen Development and validation of the VAE-NT index: a novel biomechanical parameter for distinguishing subclinical corneal abnormalities Frontiers in Bioengineering and Biotechnology very asymmetric ectasia with normal tomography dynamic corneal response parameters technique for order of preference by similarity to ideal solution keratoconus corneal biomechanics |
| title | Development and validation of the VAE-NT index: a novel biomechanical parameter for distinguishing subclinical corneal abnormalities |
| title_full | Development and validation of the VAE-NT index: a novel biomechanical parameter for distinguishing subclinical corneal abnormalities |
| title_fullStr | Development and validation of the VAE-NT index: a novel biomechanical parameter for distinguishing subclinical corneal abnormalities |
| title_full_unstemmed | Development and validation of the VAE-NT index: a novel biomechanical parameter for distinguishing subclinical corneal abnormalities |
| title_short | Development and validation of the VAE-NT index: a novel biomechanical parameter for distinguishing subclinical corneal abnormalities |
| title_sort | development and validation of the vae nt index a novel biomechanical parameter for distinguishing subclinical corneal abnormalities |
| topic | very asymmetric ectasia with normal tomography dynamic corneal response parameters technique for order of preference by similarity to ideal solution keratoconus corneal biomechanics |
| url | https://www.frontiersin.org/articles/10.3389/fbioe.2025.1598546/full |
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