{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,10,10]],"date-time":"2025-10-10T01:15:57Z","timestamp":1760058957006,"version":"build-2065373602"},"reference-count":18,"publisher":"MDPI AG","issue":"5","license":[{"start":{"date-parts":[[2025,5,9]],"date-time":"2025-05-09T00:00:00Z","timestamp":1746748800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"name":"TEDCO Maryland Innovation Initiative","award":["MII_0922-002_2","RL5GM118972","U54MD013376"],"award-info":[{"award-number":["MII_0922-002_2","RL5GM118972","U54MD013376"]}]},{"name":"National Institute of General Medical Sciences of the National Institutes of Health (NIH)","award":["MII_0922-002_2","RL5GM118972","U54MD013376"],"award-info":[{"award-number":["MII_0922-002_2","RL5GM118972","U54MD013376"]}]},{"name":"National Institute on Minority Health and Health Disparities of the NIH","award":["MII_0922-002_2","RL5GM118972","U54MD013376"],"award-info":[{"award-number":["MII_0922-002_2","RL5GM118972","U54MD013376"]}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["IJERPH"],"abstract":"<jats:p>This study aimed to evaluate the effectiveness of an innovative platform (the Bilateral Corneal Symmetry 3-D Analyzer\u2014BiCSA) and a novel corneal symmetry index (the Volume Between Spheres\u2014VBS) in differentiating normal corneas from those with keratoconus. Pentacam imaging data from 30 healthy corneas and 30 keratoconus cases were analyzed. BiCSA was utilized to determine the VBS for each case. Statistical analyses included comparing mean VBS values between groups and assessing sensitivity, specificity, and positive predictive values (PPVs). Keratoconus patients exhibited significantly higher VBS scores compared to healthy controls, particularly within the central 4.0 mm zone (11.4 versus 6.3). Using a VBS threshold of 11.3 in the central zone identified 40% of keratoconus cases (40% sensitivity), but 100% of cases surpassing the threshold were keratoconus (100% PPV). Lowering the threshold to 10.4 increased case detection to 90% while maintaining a high PPV (84.2%). These findings suggest that VBS, particularly when focused on the central 4.0 mm zone, can be a valuable tool for early keratoconus screening and identifying potential corneal abnormalities requiring further clinical evaluation. No healthy control corneas in this study exceeded a VBS threshold of 11.4 at 4 mm, indicating that values above this warrant further investigation.<\/jats:p>","DOI":"10.3390\/ijerph22050747","type":"journal-article","created":{"date-parts":[[2025,5,9]],"date-time":"2025-05-09T08:20:23Z","timestamp":1746778823000},"page":"747","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Screening with the Bilateral Corneal Symmetry 3-D Analyzer"],"prefix":"10.3390","volume":"22","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-4249-3304","authenticated-orcid":false,"given":"Shiva","family":"Mehravaran","sequence":"first","affiliation":[{"name":"Department of Biology, School of Computer, Mathematical, and Natural Sciences, Morgan State University, Baltimore, MD 21251, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2798-038X","authenticated-orcid":false,"given":"Allen","family":"Eghrari","sequence":"additional","affiliation":[{"name":"Department of Ophthalmology, Johns Hopkins University School of Medicine, Baltimore, MD 21287, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Siamak","family":"Yousefi","sequence":"additional","affiliation":[{"name":"Department of Ophthalmology and Department of Genetics, Genomics, and Informatics, University of Tennessee Health Science Center, Memphis, TN 38136, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3318-2851","authenticated-orcid":false,"given":"Fahmi","family":"Khalifa","sequence":"additional","affiliation":[{"name":"Department of Electrical and Computer Engineering, School of Engineering, Morgan State University, Baltimore, MD 21251, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Guita","family":"Ghiasi","sequence":"additional","affiliation":[{"name":"Department of Biology, School of Computer, Mathematical, and Natural Sciences, Morgan State University, Baltimore, MD 21251, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Azadeh","family":"Farahi","sequence":"additional","affiliation":[{"name":"Noor Ophthalmology Research Center, Tehran P.O. Box 3475-19395, Iran"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1968","published-online":{"date-parts":[[2025,5,9]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"1475","DOI":"10.1136\/bjophthalmol-2016-309841","article-title":"Intereye Asymmetry in Bilateral Keratoconus, Keratoconus Suspect and Normal Eyes and Its Relationship with Disease Severity","volume":"101","author":"Naderan","year":"2017","journal-title":"Br. J. Ophthalmol."},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"275","DOI":"10.1016\/j.jcrs.2015.09.020","article-title":"Accuracy of Machine Learning Classifiers Using Bilateral Data from a Scheimpflug Camera for Identifying Eyes with Preclinical Signs of Keratoconus","volume":"42","author":"Dienes","year":"2016","journal-title":"J. Cataract Refract. 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[Ph.D. Thesis, Morgan State University]."},{"key":"ref_6","doi-asserted-by":"crossref","first-page":"4275","DOI":"10.1167\/iovs.15-16710","article-title":"Corneal Shape, Volume, and Interocular Symmetry: Parameters to Optimize the Design of Biosynthetic Corneal Substitutes","volume":"56","author":"Durr","year":"2015","journal-title":"Investig. Ophthalmol. Vis. Sci."},{"key":"ref_7","doi-asserted-by":"crossref","unstructured":"Mehravaran, S., Dehzangi, I., and Rahman, M. (2021). Interocular Symmetry Analysis of Corneal Elevation Using the Fellow Eye as the Reference Surface and Machine Learning. Healthcare, 9.","DOI":"10.3390\/healthcare9121738"},{"key":"ref_8","doi-asserted-by":"crossref","first-page":"33","DOI":"10.1016\/j.ajo.2020.06.005","article-title":"Corneal Topography Raw Data Classification Using a Convolutional Neural Network","volume":"219","author":"Bouvet","year":"2020","journal-title":"Am. J. 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Technol."},{"key":"ref_12","doi-asserted-by":"crossref","unstructured":"Yousefi, S., Yousefi, E., Takahashi, H., Hayashi, T., Tampo, H., Inoda, S., Arai, Y., and Asbell, P. (2018). Keratoconus Severity Identification Using Unsupervised Machine Learning. PLoS ONE, 13.","DOI":"10.1371\/journal.pone.0205998"},{"key":"ref_13","doi-asserted-by":"crossref","first-page":"8162567","DOI":"10.1155\/2019\/8162567","article-title":"KeratoDetect: Keratoconus Detection Algorithm Using Convolutional Neural Networks","volume":"2019","author":"Lavric","year":"2019","journal-title":"Comput. Intell. Neurosci."},{"key":"ref_14","doi-asserted-by":"crossref","first-page":"803","DOI":"10.3928\/1081597X-20160629-01","article-title":"Detection of Keratoconus with a New Biomechanical Index","volume":"32","author":"Vinciguerra","year":"2016","journal-title":"J. Refract. 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(US20240074654A1), U.S. Patent."}],"container-title":["International Journal of Environmental Research and Public Health"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/1660-4601\/22\/5\/747\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,9]],"date-time":"2025-10-09T17:30:07Z","timestamp":1760031007000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/1660-4601\/22\/5\/747"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,5,9]]},"references-count":18,"journal-issue":{"issue":"5","published-online":{"date-parts":[[2025,5]]}},"alternative-id":["ijerph22050747"],"URL":"https:\/\/doi.org\/10.3390\/ijerph22050747","relation":{},"ISSN":["1660-4601"],"issn-type":[{"type":"electronic","value":"1660-4601"}],"subject":[],"published":{"date-parts":[[2025,5,9]]}}}