[A comparison of device-based diagnostic methods for keratoconus].

Area of Science:

• Ophthalmology
• Medical Diagnostics
• Corneal Imaging

Background:

• Keratoconus diagnosis relies on various clinical examination parameters.
• Modern devices provide extensive data on corneal topography, tomography, and biomechanics.

Purpose of the Study:

• To evaluate the diagnostic support provided by modern screening methods for keratoconus.
• To compare the efficacy of different diagnostic indices in identifying keratoconus.

Main Methods:

• Prospective study including 93 keratoconus eyes and 107 healthy control eyes.
• Corneal analysis using TMS-5 topographer, Pentacam, and Ocular Response Analyzer (ORA).
• Receiver operator characteristics (ROC) analysis to determine the performance of various keratoconus indices (AUC).

Main Results:

• All tested parameters showed statistically significant differences between keratoconus and control groups (p ≤ 0.0001).
• Topography and tomography indices (TMS-5: SAI, KSI; Pentacam: ISV, TKC) demonstrated high diagnostic performance (AUC > 0.909).
• Biomechanical indices from ORA (CH, CRF, KMI) showed slightly lower, yet still significant, performance.

Conclusions:

• Corneal topography and tomography are more reliable for keratoconus diagnosis than biomechanical property evaluation.
• Specific indices like SAI, KSI, ISV, and TKC offer superior recognition rates compared to ORA's KMI.
• No single parameter is adequate for a definitive keratoconus diagnosis; comprehensive evaluation is necessary.