New objective lens density quantification method using swept-source optical coherence tomography technology: Comparison with existing methods

To assess a new objective cataract grading method based on lens densitometry on swept-source optical coherence tomography (SS-OCT) scans provided by the IOLMaster 700.Rothschild Foundation, Paris, France.Prospective case series.All patients consulting for cataract evaluation who provided their consent to participate in the study were included. A history of eye surgery, corneal or retinal disorders, and ocular dryness were exclusion criteria. The average lens densitometry was measured with SS-OCT scans using ImageJ software. The ocular scatter index (OSI) measured with a double-pass aberrometer (Optical Quality Analysis System), the Pentacam nucleus staging (hereafter referred to as nuclear staging) score, and mean nuclear staging were also measured and compared with the mean lens densitometry.One hundred ten eyes (51 with cataract and 59 controls) were included. The average lens densitometry measurements were repeatable (P = .99, analysis of variance). The repeatability limit was 2.50 pixel units. The average lens density was correlated with the OSI (r2 = 0.52, P < .01), nuclear staging score (r2 = 0.75, P < .01), and mean nuclear staging (r2 = 0.41, P < .01). An average lens density greater than 82.9 pixel units was the cutoff threshold for cataract, with a sensitivity of 73.9% and a specificity of 91.2%.The average lens density measured by SS-OCT was a repeatable and reliable objective cataract grading method. It was correlated with OSI measurement. If the average lens density was greater than 82.9 pixel units and the patient reported visual impairment, cataract surgery might be discussed.