{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,28]],"date-time":"2026-10-28T23:17:03Z","timestamp":1793229423652,"version":"4.5.0"},"reference-count":41,"publisher":"Elsevier BV","issue":"3","license":[{"start":{"date-parts":[[2025,6,1]],"date-time":"2025-06-01T00:00:00Z","timestamp":1748736000000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/www.elsevier.com\/tdm\/userlicense\/1.0\/"},{"start":{"date-parts":[[2025,6,1]],"date-time":"2025-06-01T00:00:00Z","timestamp":1748736000000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/www.elsevier.com\/legal\/tdmrep-license"}],"funder":[{"DOI":"10.13039\/501100001809","name":"National Natural Science Foundation of China","doi-asserted-by":"publisher","award":["82271118"],"award-info":[{"award-number":["82271118"]}],"id":[{"id":"10.13039\/501100001809","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100012166","name":"National Key Research and Development Program of China","doi-asserted-by":"publisher","award":["2022YFC2404502"],"award-info":[{"award-number":["2022YFC2404502"]}],"id":[{"id":"10.13039\/501100012166","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["clinicalkey.com","clinicalkey.com.au","clinicalkey.es","clinicalkey.fr","clinicalkey.jp","contactlensjournal.com","elsevier.com","sciencedirect.com"],"crossmark-restriction":true},"short-container-title":["Contact Lens and Anterior Eye"],"published-print":{"date-parts":[[2025,6]]},"DOI":"10.1016\/j.clae.2025.102382","type":"journal-article","created":{"date-parts":[[2025,2,12]],"date-time":"2025-02-12T17:25:38Z","timestamp":1739381138000},"page":"102382","update-policy":"https:\/\/doi.org\/10.1016\/elsevier_cm_policy","source":"Crossref","is-referenced-by-count":6,"title":["Ethnicity optimized indices enhance the diagnostic efficiency of early Keratoconus: A multicenter validation study"],"prefix":"10.1016","volume":"48","author":[{"given":"Yan","family":"Huo","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ruisi","family":"Xie","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jing","family":"Li","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jie","family":"Hou","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Haohan","family":"Zou","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1257-6635","authenticated-orcid":false,"given":"Yan","family":"Wang","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"78","reference":[{"key":"10.1016\/j.clae.2025.102382_b0005","doi-asserted-by":"crossref","DOI":"10.1016\/j.clae.2021.101559","article-title":"Keratoconus: An updated review","volume":"45","author":"Santodomingo-Rubido","year":"2022","journal-title":"Cont Lens Anterior Eye"},{"key":"10.1016\/j.clae.2025.102382_b0010","doi-asserted-by":"crossref","first-page":"140","DOI":"10.1016\/j.ajo.2017.06.031","article-title":"Keratoconus screening indices and their diagnostic ability to distinguish normal from ectatic corneas","volume":"181","author":"Shetty","year":"2017","journal-title":"Am J Ophthalmol"},{"key":"10.1016\/j.clae.2025.102382_b0015","doi-asserted-by":"crossref","first-page":"173","DOI":"10.1038\/s41433-020-1039-1","article-title":"A review of imaging modalities for detecting early keratoconus","volume":"35","author":"Zhang","year":"2021","journal-title":"Eye (lond)"},{"key":"10.1016\/j.clae.2025.102382_b0020","doi-asserted-by":"crossref","first-page":"P205","DOI":"10.1016\/j.ophtha.2023.12.038","article-title":"Corneal ectasia preferred practice pattern\u00ae","volume":"131","author":"Jhanji","year":"2024","journal-title":"Ophthalmology"},{"issue":"12","key":"10.1016\/j.clae.2025.102382_b0025","doi-asserted-by":"crossref","first-page":"21","DOI":"10.1167\/tvst.12.12.21","article-title":"Structure-function relationship in keratoconus: Spatial and depth vision","volume":"12","author":"Kumar","year":"2023","journal-title":"Transl vis Sci Technol"},{"key":"10.1016\/j.clae.2025.102382_b0030","doi-asserted-by":"crossref","first-page":"37","DOI":"10.1016\/j.ophtha.2007.03.073","article-title":"Risk assessment for ectasia after corneal refractive surgery","volume":"115","author":"Randleman","year":"2008","journal-title":"Ophthalmology"},{"key":"10.1016\/j.clae.2025.102382_b0035","doi-asserted-by":"crossref","first-page":"107","DOI":"10.1016\/j.ophtha.2023.07.030","article-title":"Advanced corneal imaging in keratoconus: A report by the American Academy of Ophthalmology","volume":"131","author":"Kuo","year":"2024","journal-title":"Ophthalmology"},{"key":"10.1016\/j.clae.2025.102382_b0040","doi-asserted-by":"crossref","unstructured":"Vinciguerra R, Ambr\u00f3sio R, JR, Elsheikh A, Roberts CJ, Lopes B, Morenghi E, et al. Detection of keratoconus with a new biomechanical index. J Refract Surg 2016;32:803-10. Doi: 10.3928\/1081597X-20160629-01.","DOI":"10.3928\/1081597X-20160629-01"},{"key":"10.1016\/j.clae.2025.102382_b0045","doi-asserted-by":"crossref","first-page":"1337","DOI":"10.1007\/s00417-023-06307-7","article-title":"Corneal biomechanics in early diagnosis of keratoconus using artificial intelligence","volume":"262","author":"Huo","year":"2024","journal-title":"Graefes Arch Clin Exp Ophthalmol"},{"key":"10.1016\/j.clae.2025.102382_b0050","doi-asserted-by":"crossref","first-page":"1158299","DOI":"10.3389\/fbioe.2023.1158299","article-title":"Screening of sensitive in vivo characteristics for early keratoconus diagnosis: A multicenter study","volume":"11","author":"Chen","year":"2023","journal-title":"Front Bioeng Biotechnol"},{"key":"10.1016\/j.clae.2025.102382_b0055","doi-asserted-by":"crossref","first-page":"e27363","DOI":"10.2196\/27363","article-title":"Machine learning algorithms to detect subclinical keratoconus: Systematic review","volume":"9","author":"Maile","year":"2021","journal-title":"JMIR Med Inform"},{"key":"10.1016\/j.clae.2025.102382_b0060","article-title":"Artificial intelligence in ophthalmology: The path to the real-world clinic","volume":"4","author":"Li","year":"2023","journal-title":"Cell Rep Med"},{"key":"10.1016\/j.clae.2025.102382_b0065","doi-asserted-by":"crossref","first-page":"158","DOI":"10.1136\/bjophthalmol-2019-315651","article-title":"Artificial intelligence for anterior segment diseases: Emerging applications in ophthalmology","volume":"105","author":"Ting","year":"2021","journal-title":"Br J Ophthalmol"},{"key":"10.1016\/j.clae.2025.102382_b0070","doi-asserted-by":"crossref","unstructured":"Ambr\u00f3sio Jr. R Jr., Lopes BT, Faria-Correia F, Salom\u00e3o MQ, B\u00fchren J, Roberts CJ, et al. Integration of Scheimpflug-based corneal tomography and biomechanical assessments for enhancing ectasia detection. J Refract Surg 2017;33:434-43. Doi: 10.3928\/1081597X-20170426-02.","DOI":"10.3928\/1081597X-20170426-02"},{"key":"10.1016\/j.clae.2025.102382_b0075","doi-asserted-by":"crossref","first-page":"671","DOI":"10.1080\/08820538.2021.1896752","article-title":"Comparison of the morphological and biomechanical characteristics of keratoconus, forme fruste keratoconus, and normal corneas","volume":"36","author":"Guo","year":"2021","journal-title":"Semin Ophthalmol"},{"key":"10.1016\/j.clae.2025.102382_b0080","doi-asserted-by":"crossref","first-page":"328","DOI":"10.1016\/j.jcrs.2018.10.030","article-title":"Accuracy of Scheimpflug-derived corneal biomechanical and tomographic indices for detecting subclinical and mild keratectasia in a South Asian population","volume":"45","author":"Kataria","year":"2019","journal-title":"J Cataract Refract Surg"},{"key":"10.1016\/j.clae.2025.102382_b0085","doi-asserted-by":"crossref","first-page":"118","DOI":"10.1080\/02713683.2019.1658787","article-title":"Early diagnosis of keratoconus in Chinese myopic eyes by combining Corvis ST with Pentacam","volume":"45","author":"Zhang","year":"2020","journal-title":"Curr Eye Res"},{"key":"10.1016\/j.clae.2025.102382_b0090","doi-asserted-by":"crossref","unstructured":"Ambr\u00f3sio Jr. R Jr., Machado AP, Le\u00e3o E, Lyra JMG, Salom\u00e3o MQ, Esporcatte LGP, et al. Optimized artificial intelligence for enhanced ectasia detection using Scheimpflug-based corneal tomography and biomechanical data. Am J Ophthalmol 2023;251:126-42. Doi: 10.1016\/j.ajo.2022.12.016.","DOI":"10.1016\/j.ajo.2022.12.016"},{"key":"10.1016\/j.clae.2025.102382_b0095","article-title":"Corneal biomechanics differences between Chinese and Caucasian healthy subjects","volume":"9","author":"Vinciguerra","year":"2022","journal-title":"Front Med (lausanne)"},{"key":"10.1016\/j.clae.2025.102382_b0100","doi-asserted-by":"crossref","first-page":"2003","DOI":"10.1167\/iovs.16-19226","article-title":"Associations of biomechanical properties of the cornea with environmental and metabolic factors in an elderly population: theALIENOR Study","volume":"57","author":"Schweitzer","year":"2016","journal-title":"Invest Ophthalmol vis Sci"},{"key":"10.1016\/j.clae.2025.102382_b0105","doi-asserted-by":"crossref","first-page":"35","DOI":"10.1167\/iovs.62.2.35","article-title":"Associations between regional environment and cornea-related morphology of the eye in young adults: A large-scale multicenter cross-sectional study","volume":"62","author":"Ma","year":"2021","journal-title":"Invest Ophthalmol vis Sci"},{"key":"10.1016\/j.clae.2025.102382_b0110","doi-asserted-by":"crossref","first-page":"971","DOI":"10.1136\/bjo.2009.162735","article-title":"The genetics of central corneal thickness","volume":"94","author":"Dimasi","year":"2010","journal-title":"Br J Ophthalmol"},{"key":"10.1016\/j.clae.2025.102382_b0115","doi-asserted-by":"crossref","first-page":"182","DOI":"10.1016\/j.ajo.2023.04.002","article-title":"Detection of keratoconus with a new Corvis biomechanical index optimized for Chinese populations","volume":"252","author":"Vinciguerra","year":"2023","journal-title":"Am J Ophthalmol"},{"key":"10.1016\/j.clae.2025.102382_b0120","doi-asserted-by":"crossref","first-page":"e39313","DOI":"10.1371\/journal.pone.0039313","article-title":"Beijing Eye Study Group. Prevalence and associations of steep cornea\/keratoconus in Greater Beijing. The Beijing eye study","volume":"7","author":"Xu","year":"2012","journal-title":"PLoS One"},{"key":"10.1016\/j.clae.2025.102382_b0125","doi-asserted-by":"crossref","first-page":"56","DOI":"10.1016\/j.ajo.2018.04.027","article-title":"Prevalence and incidence of keratoconus in South Korea: A nationwide population-based study","volume":"192","author":"Hwang","year":"2018","journal-title":"Am J Ophthalmol"},{"key":"10.1016\/j.clae.2025.102382_b0130","doi-asserted-by":"crossref","first-page":"3136","DOI":"10.1038\/s41433-024-03251-6","article-title":"Impacts of keratoconus on quality of life: A qualitative study","volume":"38","author":"Fan","year":"2024","journal-title":"Eye (lond)"},{"key":"10.1016\/j.clae.2025.102382_b0135","doi-asserted-by":"crossref","first-page":"1187","DOI":"10.1097\/ICO.0000000000003263","article-title":"Mental health impact of keratoconus: A systematic review","volume":"42","author":"Durakovic","year":"2023","journal-title":"Cornea"},{"key":"10.1016\/j.clae.2025.102382_b0140","doi-asserted-by":"crossref","first-page":"7","DOI":"10.1016\/j.ajo.2018.08.054","article-title":"Enhanced ectasia detection using corneal tomography and biomechanics","volume":"197","author":"Ferreira-Mendes","year":"2019","journal-title":"Am J Ophthalmol"},{"key":"10.1016\/j.clae.2025.102382_b0145","doi-asserted-by":"crossref","first-page":"185","DOI":"10.1016\/j.ajo.2024.01.009","article-title":"Corneal biomechanical properties to predict prognosis of abnormal tomographic corneas: A prospective cohort study","volume":"259","author":"Huo","year":"2024","journal-title":"Am J Ophthalmol"},{"key":"10.1016\/j.clae.2025.102382_b0150","doi-asserted-by":"crossref","first-page":"1311","DOI":"10.1007\/s00417-022-05916-y","article-title":"Biomechanical properties analysis of forme fruste keratoconus and subclinical keratoconus","volume":"261","author":"Huo","year":"2023","journal-title":"Graefes Arch Clin Exp Ophthalmol"},{"key":"10.1016\/j.clae.2025.102382_b0155","doi-asserted-by":"crossref","first-page":"837","DOI":"10.2307\/2531595","article-title":"Comparing the areas under two or more correlated receiver operating characteristic curves: A nonparametric approach","volume":"44","author":"DeLong","year":"1988","journal-title":"Biometrics"},{"key":"10.1016\/j.clae.2025.102382_b0160","doi-asserted-by":"crossref","first-page":"885","DOI":"10.1016\/j.ajo.2013.12.024","article-title":"Corneal biomechanics as a function of intraocular pressure and pachymetry by dynamic infrared signal and Scheimpflug imaging analysis in normal eyes","volume":"157","author":"Huseynova","year":"2014","journal-title":"Am J Ophthalmol"},{"key":"10.1016\/j.clae.2025.102382_b0165","doi-asserted-by":"crossref","unstructured":"Vinciguerra R, Elsheikh A, Roberts CJ, Ambr\u00f3sio Jr. R Jr., Kang DSY, Lopes BT, et al. Influence of pachymetry and intraocular pressure on dynamic corneal response parameters in healthy patients. J Refract Surg 2016;32:550-61. Doi: 10.3928\/1081597X-20160524-01.","DOI":"10.3928\/1081597X-20160524-01"},{"key":"10.1016\/j.clae.2025.102382_b0170","doi-asserted-by":"crossref","first-page":"1475","DOI":"10.1098\/rsif.2010.0108","article-title":"Characterization of age-related variation in corneal biomechanical properties","volume":"7","author":"Elsheikh","year":"2010","journal-title":"J R Soc Interface"},{"key":"10.1016\/j.clae.2025.102382_b0175","doi-asserted-by":"crossref","first-page":"339","DOI":"10.1186\/s12886-021-02102-2","article-title":"Application of a Scheimpflug-based biomechanical analyser and tomography in the early detection of subclinical keratoconus in Chinese patients","volume":"21","author":"Liu","year":"2021","journal-title":"BMC Ophthalmol"},{"key":"10.1016\/j.clae.2025.102382_b0180","doi-asserted-by":"crossref","first-page":"4962","DOI":"10.1038\/s41598-021-84370-y","article-title":"Accuracy of new Corvis ST parameters for detecting subclinical and clinical keratoconus eyes in a Chinese population","volume":"11","author":"Ren","year":"2021","journal-title":"Sci Rep"},{"key":"10.1016\/j.clae.2025.102382_b0185","doi-asserted-by":"crossref","first-page":"778","DOI":"10.1016\/j.jcrs.2018.12.015","article-title":"Assessment of corneal biomechanical parameters in healthy and keratoconic eyes using dynamic bidirectional applanation device and dynamic Scheimpflug analyzer","volume":"45","author":"Herber","year":"2019","journal-title":"J Cataract Refract Surg"},{"key":"10.1016\/j.clae.2025.102382_b0190","doi-asserted-by":"crossref","unstructured":"Sedaghat MR, Momeni-Moghaddam H, Ambr\u00f3sio Jr. R Jr., Heidari HR, Maddah N, Danesh Z, et al. Diagnostic ability of corneal shape and biomechanical parameters for detecting frank keratoconus. Cornea 2018;37:1025-34. Doi: 10.1097\/ICO.0000000000001639.","DOI":"10.1097\/ICO.0000000000001639"},{"key":"10.1016\/j.clae.2025.102382_b0195","doi-asserted-by":"crossref","first-page":"36","DOI":"10.1167\/tvst.9.2.36","article-title":"Protecting data privacy in the age of AI-enabled ophthalmology","volume":"9","author":"Tom","year":"2020","journal-title":"Transl vis Sci Technol"},{"key":"10.1016\/j.clae.2025.102382_b0200","doi-asserted-by":"crossref","unstructured":"Henriquez MA, Hadid M, Izquierdo Jr. L Jr. A systematic review of subclinical keratoconus and forme fruste keratoconus. J Refract Surg 2020;36:270-9. Doi: 10.3928\/1081597X-20200212-03.","DOI":"10.3928\/1081597X-20200212-03"},{"key":"10.1016\/j.clae.2025.102382_b0205","doi-asserted-by":"crossref","first-page":"840","DOI":"10.3928\/1081597X-20181012-01","article-title":"Tomographic and biomechanical Scheimpflug imaging for keratoconus characterization: A validation of current indices","volume":"34","author":"Steinberg","year":"2018","journal-title":"J Refract Surg"}],"container-title":["Contact Lens and Anterior Eye"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/api.elsevier.com\/content\/article\/PII:S1367048425000165?httpAccept=text\/xml","content-type":"text\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/api.elsevier.com\/content\/article\/PII:S1367048425000165?httpAccept=text\/plain","content-type":"text\/plain","content-version":"vor","intended-application":"text-mining"}],"deposited":{"date-parts":[[2025,11,5]],"date-time":"2025-11-05T20:20:54Z","timestamp":1762374054000},"score":1,"resource":{"primary":{"URL":"https:\/\/linkinghub.elsevier.com\/retrieve\/pii\/S1367048425000165"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,6]]},"references-count":41,"journal-issue":{"issue":"3","published-print":{"date-parts":[[2025,6]]}},"alternative-id":["S1367048425000165"],"URL":"https:\/\/doi.org\/10.1016\/j.clae.2025.102382","relation":{},"ISSN":["1367-0484"],"issn-type":[{"value":"1367-0484","type":"print"}],"subject":[],"published":{"date-parts":[[2025,6]]},"assertion":[{"value":"Elsevier","name":"publisher","label":"This article is maintained by"},{"value":"Ethnicity optimized indices enhance the diagnostic efficiency of early Keratoconus: A multicenter validation study","name":"articletitle","label":"Article Title"},{"value":"Contact Lens and Anterior Eye","name":"journaltitle","label":"Journal Title"},{"value":"https:\/\/doi.org\/10.1016\/j.clae.2025.102382","name":"articlelink","label":"CrossRef DOI link to publisher maintained version"},{"value":"article","name":"content_type","label":"Content Type"},{"value":"\u00a9 2025 British Contact Lens Association. Published by Elsevier Ltd. All rights are reserved, including those for text and data mining, AI training, and similar technologies.","name":"copyright","label":"Copyright"}],"article-number":"102382"}}