Discrimination between surgical and nonsurgical nuclear cataracts based on ROC analysis.

PURPOSE The aim of this article is to propose a quantitative methodology for determining a criterion to discriminate the nonsurgical nuclear cataract from the surgical one taking into account objective measures of intraocular scattering in patients with good visual acuity (>0.6). METHODS Two groups of subjects were taken into account: a control group and a group with nuclear cataracts. At a first stage, eyes belonging to the cataract group were classified into "nonsurgical" and "surgical" cataracts by ophthalmologists at their clinical settings. At a second stage a double-pass instrument was also used to determine the objective scatter index (OSI) at the laboratory. Receiver operating characteristic (ROC) curves were used to analyze OSI values to determine a value able to separate between nonsurgical and surgical cataracts. RESULTS We obtained statistically significant differences among the control and both nuclear cataract groups (p < 0.05). ROC curves determined an OSI criterion level (of 2.1) to suggest surgery in nuclear cataracts with an area under curve of 0.83, i.e. with 80% of sensitivity and 80% of specificity. CONCLUSIONS ROC analysis allows separating both groups of nuclear cataract, and we determined a value of OSI in nuclear cataract quantification for surgery.