A comparative study of optical coherence tomography and slit-lamp based grading of cataract

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Purpose : Established methods of grading cataract are susceptible to error due to their subjective nature as well as variation in slit-lamp settings during assessment. Furthermore, grading systems such as the Lens Opacities Classification System III (LOCS III) are only applicable to age-related forms of the condition. Optical coherence tomography (OCT) offers the potential to provide an objective method of imaging and grading all forms of cataract. An observational clinical study was performed to compare anterior segment OCT imaging with traditional, slit-lamp based grading. Methods : Crystalline lens images of 60 eyes from 38 adults aged 50 to 79 years (mean 62.97+/-9.99) were captured using a Nikon FS-3 slit-lamp photo-biomicroscope and a Zeiss Visante anterior segment OCT. Prior to imaging, participants were assessed for habitual visual acuity (logMAR), contrast sensitivity (Pelli-Robson) and straylight scatter (Oculus C-Quant). Pupils were then dilated with 1% tropicamide to obtain optimum images of the crystalline lens. The slit-lamp images were graded for age-related cataract (nuclear colour and opalescence) using the LOCS III. Raw OCT data were analysed in MATLAB to determine a pixel intensity ratio for the nucleus of each crystalline lens (see figure). Linear regression compared LOCS III nuclear opalescence and nuclear colour scores to OCT pixel intensity ratios. Results : Age-related nuclear cataract was the predominant cataract type, with LOCS III mean scores of 2.04+/-0.63 for nuclear opalescence and 1.65+/-0.71 for nuclear colour. Cortical and posterior subcapsular cataract were present at low levels (0.32+/-0.51; 0.12+/-0.12 respectively). Mean OCT nuclear pixel intensity ratio was 1.077+/-0.04. Regression analyses revealed significant relations between pixel intensity ratio and nuclear opalescence (F(1,58)=8.24, p
Original languageEnglish
Title of host publicationUnknown Host Publication
PublisherLippincott Williams and Wilkins
Number of pages2516
Publication statusPublished online - Sept 2016
EventAssociation for Research in Vision and Ophthalmology - United States of America
Duration: 1 Sept 2016 → …


ConferenceAssociation for Research in Vision and Ophthalmology
Period1/09/16 → …


  • cataract
  • ocular coherence tomography (OCT)
  • slit lamp
  • LOCS III grading


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