title: Measurement of lens density using Scheimpflug imaging system as a screening test in the field of health examination for age-related cataract.
abstract: OBJECTIVE
  To assess Pentacam (Oculus, Wetzlar, Germany) Scheimpflug quantitative images in evaluating lens density and providing objective measurements to suggest optimal time of cataract surgery in the field of health examination.
  
  
  METHODS
  Two hundred and twenty-nine eyes with age-related cataract were enrolled. Lens density was measured using Pentacam. All Pentacam images were exported to ImageJ (NIH, Bethesda, Maryland, USA) for quantitative analysis. Average lens density (ALD) and nuclear lens density (NLD) were calculated. Lens density was also evaluated by built-in Pentacam Nucleus Staging (PNS) software. Slit-lamp microscopy was performed for cataract grading according to Lens Opacification Classification System III (LOCS III). The best-corrected visual acuity (BCVA) was measured. All measurements were compared between the cataract surgery and non-cataract surgery groups.
  
  
  RESULTS
  The measurements of Pentacam images significantly correlated with LOCS III for nuclear opalescence (NO) and nuclear colour (NC) grading (p<0.01). Pentacam ImageJ showed higher correlation than PNS. The mean NLD was most highly correlated with NO (r=0.8833) and NC (r=0.6815). The maximum ALD was most highly correlated with cortical opacity (r=0.5381). All Pentacam measurements of lens density and BCVA were significantly different between the cataract surgery and non-surgery groups (p<0.01). The optimised cut-off values to perform cataract surgery for mean NLD and maximum ALD were 26 and 74, respectively (p<0.01).
  
  
  CONCLUSIONS
  The Pentacam ImageJ method provided objective measurements to evaluate cataracts needing surgery. The method has the potential to be generally applied in the field of health examination and is effective in screening patients with cataract.
authors.affiliation: Department of Ophthalmology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea Department of Preventive Medicine, Catholic University School of Medicine, Seoul, Republic of Korea.
authors.forename: Dong Hui
authors.initials: DH
authors.lastname: Lim
authors.affiliation: Department of Ophthalmology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea.
authors.forename: Tae Hyup
authors.initials: TH
authors.lastname: Kim
authors.affiliation: Department of Ophthalmology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea.
authors.forename: Eui-Sang
authors.initials: ES
authors.lastname: Chung
authors.affiliation: Department of Ophthalmology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea.
authors.forename: Tae-Young
authors.initials: TY
authors.lastname: Chung
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000375:Aging; D002386:Cataract / Q000145:classification / Q000175:diagnosis*; D005260:Female; D006801:Humans; D007908:Lens, Crystalline / Q000473:pathology*; D008297:Male; D008875:Middle Aged; D010781:Photography / Q000379:methods*; D010808:Physical Examination; D015351:Vision Screening / Q000379:methods*; D014792:Visual Acuity / Q000502:physiology
keywords: Diagnostic tests/Investigation; Imaging; Lens and zonules; Public health