Advanced anterior segment imaging in keratoconus: a review

Area of Science:

• Ophthalmology
• Corneal Imaging
• Biomedical Engineering

Background:

• Keratoconus is a progressive corneal disease affecting shape and thickness.
• Early detection and characterization are crucial for effective management.
• Advances in imaging technology offer new diagnostic capabilities.

Purpose of the Study:

• To review recent advances in anterior segment imaging for keratoconus.
• To highlight the role of various imaging modalities in understanding keratoconus pathology.
• To discuss the clinical applications of these technologies in diagnosis and treatment monitoring.

Main Methods:

• Computerized corneal tomography for shape and thickness analysis.
• Automated screening indices for early detection.
• In vivo biomechanical assessment.
• Optical coherence tomography for epithelial and Descemet's membrane evaluation.
• In vivo confocal microscopy for cellular analysis.

Main Results:

• Tomography reveals progressive changes in corneal surfaces and thickness.
• Screening indices aid in identifying suspicious cases.
• Biomechanical properties of keratoconic corneas can be measured clinically.
• OCT shows epithelial alterations and aids in managing acute corneal hydrops and post-crosslinking assessment.
• Confocal microscopy visualizes cellular changes and neovascularization in acute corneal hydrops.

Conclusions:

• Anterior segment imaging has significantly improved early keratoconus detection.
• These technologies provide detailed insights into keratoconus pathophysiology.
• Advanced imaging facilitates clinical assessment, diagnosis, and monitoring of treatment outcomes.