Abstract
The purpose of this study was to compare central corneal thickness, thinnest corneal thickness, and the thinnest point of the cornea between Pentacam and anterior segment optical coherence tomography (ASOCT) in patients with dry eye disease (DED). This cross-sectional study included 195 participants between November 2015–June 2017. DED was diagnosed using the Asia Dry Eye Society criteria and further divided into mild and severe DED based on kerato-conjunctival vital staining. Central corneal thickness, thinnest corneal thickness, and the thinnest point of the cornea measured by Pentacam and ASOCT were compared, and Pearson’s correlation coefficients were estimated. The differences in central corneal thickness and the thinnest corneal thickness between Pentacam and ASOCT were analysed using Bland–Altman and multivariate regression analyses adjusted for age and sex. This study included 70 non-DED subjects and 52 patients with mild and 73 with severe DED. The Pentacam and ASOCT measurements of central corneal thickness and thinnest corneal thickness were strongly correlated, but the respective values were higher when measured with Pentacam. The Bland–Altman analysis revealed differences in central corneal thickness (non DED, 11.8; mild DED, 13.2; severe DED, 19.6) and in thinnest corneal thickness (non DED, 13.1; mild DED, 13.4; severe DED, 20.7). After adjusting for age and sex, the differences in central corneal thickness (β = 7.029 μm, 95%CI 2.528–11.530) and thinnest corneal thickness (β = 6.958 μm, 95%CI 0.037–13.879) were significantly increased in the severe-DED group. The distribution of the thinnest point of the cornea in the cornea’s inferior temporal quadrant between Pentacam and ASOCT deviated in severe DED (Pentacam: 90.4% vs. ASOCT: 83.6%). Clinicians should consider that there were significant differences in corneal-morphology assessment between the measurements with Pentacam and ASOCT in severe DED.
Highlights
Central corneal thickness (CCT) is a corneal health indicator, including of metabolism and hydration status [1], and an important parameter for the characterization of corneal disease including keratoconus and Fuchs dystrophy due to the barrier and endothelial pump function of the cornea [2,3,4]
An accurate CCT value is essential for the adjustment of intraocular pressure (IOP) in each patient with glaucoma, as CCT is a potent confounder of most tonometry techniques [8]
The kerato-conjunctival vital staining score was increased in the severe-dry eye disease (DED) compared to the non-DED group, whereas it was decreased in the mild-DED group compared to the non-DED group because of the group classification in this study
Summary
Central corneal thickness (CCT) is a corneal health indicator, including of metabolism and hydration status [1], and an important parameter for the characterization of corneal disease including keratoconus and Fuchs dystrophy due to the barrier and endothelial pump function of the cornea [2,3,4]. Accurate measurements of CCT affect the outcomes of refractive surgery, corneal transplantation, and contact-lens prescriptions [5,6,7]. The incidence of dry eye disease (DED) has been increasing with the aging society and increased digital devise usage, affecting tens of millions of people worldwide [10,11,12]. DED was found to be comorbid with post cataract surgery and glaucoma treatment due to shared risk factors including aging and the long-term use of eye drops containing preservatives [14,15,16]. As contact-lens use is a risk factor of DED [13], patients with keratoconus who use hard contact lenses for suppression of the condition’s development could develop DED [17]. Many studies have been conducted on DED and CCT, reporting thinner CCT in patients with DED and that the measurement of CCT is useful for the follow up of DED [18,19,20]
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