Keratoconus detection and classification from parameters of the Corvis®ST: A study based on algorithms of machine learning

Abstract

Background and objective: In the last decades increasingly more systems of artificial intelligence have been established in medicine, which identify diseases or pathologies or discriminate them from complimentary diseases. Up to now the Corvis®ST (Corneal Visualization Scheimpflug Technology, Corvis®ST, Oculus, Wetzlar, Germany) yielded a binary index for classifying keratoconus but did not enable staging. The purpose of this study was to develop a prediction model, which mimics the topographic keratoconus classification index (TKC) of the Pentacam high resolution (HR, Oculus) with measurement parameters extracted from the Corvis®ST. Patients and methods: In this study 60 measurements from normal subjects (TKC 0) and 379 eyes with keratoconus (TKC 1–4) were recruited. After measurement with the Pentacam HR (target parameter TKC) a measurement with the Corvis®ST device was performed. From this device 6 dynamic response parameters were extracted, which were included in the Corvis biomechanical index (CBI) provided by the Corvis®ST (ARTh, SP-A1, DA ratio 1 mm, DA ratio 2 mm, A1 velocity, max. deformation amplitude). In addition to the TKC as the target, the binarized TKC (1: TKC 1–4, 0: TKC 0) was modelled. The performance of the model was validated with accuracy as an indicator for correct classification made by the algorithm. Misclassifications in the modelling were penalized by the number of stages of deviation between the modelled and measured TKC values. Results: A total of 24 different models of supervised machine learning from 6 different families were tested. For modelling of the TKC stages 0–4, the algorithm based on a support vector machine (SVM) with linear kernel showed the best performance with an accuracy of 65.1% correct classifications. For modelling of binarized TKC, a decision tree with a coarse resolution showed a superior performance with an accuracy of 95.2% correct classifications followed by the SVM with linear or quadratic kernel and a nearest neighborhood classifier with cubic kernel (94.5% each). Conclusion: This study aimed to show the principle of supervised machine learning applied to a set-up for the modelled classification of keratoconus staging. Preprocessed measurement data extracted from the Corvis®ST device were used to mimic the TKC provided by the Pentacam device with a series of different algorithms of machine learning.