Abstract
Purpose. To compare the characteristics of asymmetric keratoconic eyes and normal eyes by Fourier domain optical coherence tomography (OCT) corneal mapping. Methods. Retrospective corneal and epithelial thickness OCT data for 74 patients were compared in three groups of eyes: keratoconic (n = 22) and normal fellow eyes (n = 22) in patients with asymmetric keratoconus and normal eyes (n = 104) in healthy subjects. Areas under the curve (AUC) of receiver operator characteristic (ROC) curves for each variable were compared across groups to indicate their discrimination capacity. Results. Three variables were found to differ significantly between fellow eyes and normal eyes (all p < 0.05): minimum corneal thickness, thinnest corneal point, and central corneal thickness. These variables combined showed a high discrimination power to differentiate fellow eyes from normal eyes indicated by an AUC of 0.840 (95% CI: 0.762–0.918). Conclusions. Our findings indicate that topographically normal fellow eyes in patients with very asymmetric keratoconus differ from the eyes of healthy individuals in terms of their corneal epithelial and pachymetry maps. This type of information could be useful for an early diagnosis of keratoconus in topographically normal eyes.
Highlights
Keratoconus is a bilateral, noninflammatory corneal ectasia in which the cornea assumes a conical shape due to progressive thinning and steepening of the corneal stroma
An undetected incipient ectasia could be worsened by a refractive procedure such as LASIK, whereby the already reduced mechanical strength of the cornea is further weakened by surgery possibly causing rapid progression of the ectasia [5]
All adult patients for which complete optical coherence tomography (OCT) corneal thickness and corneal epithelial thickness data were available were identified in the databases of the two participating centers
Summary
Keratoconus is a bilateral, noninflammatory corneal ectasia in which the cornea assumes a conical shape due to progressive thinning and steepening of the corneal stroma. With a prevalence of 54 per 100 000, it is the most common primary corneal ectasia [1]. Moderate forms of keratoconus are easy to detect using several devices [2] to examine anterior corneal topography. These range from simple inexpensive devices, such as handheld keratoscopes (Placido’s disks), to sophisticated devices such as computer-assisted videokeratoscopes. The Pentacam corneal tomographer [3] or Orbscan topography system [4] is widely used to detect subtle changes and control disease progression. An undetected incipient ectasia could be worsened by a refractive procedure such as LASIK, whereby the already reduced mechanical strength of the cornea is further weakened by surgery possibly causing rapid progression of the ectasia [5]
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