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Three-Dimensional Morphogeometric and Volumetric Characterization of Cornea in Pediatric Patients With Early
Ibrahim Toprak1, Francisco Cavas2, José S Velázquez2
1Department of Ophthalmology, Faculty of Medicine, Pamukkale University, Denizli, Turkey; Department of Research and Development, VISSUM, Alicante, Spain.
Purpose:
To present morphogeometric and volumetric characteristics of the cornea and its diagnostic value in pediatric patients with keratoconus (KC) using 3-dimensional (3-D) corneal modeling.
Design:
Cross-sectional study.
Methods:
This single-center (VISSUM Innovation, Alicante, Spain) study comprised 49 eyes of 49 pediatric patients (age ≤16 years) with KC and 31 eyes of 31 healthy pediatric controls. Eyes were graded as early (n = 21) and mild KC (n = 28) based on the RETICS (Thematic Network for Co-Operative Research in Health) classification system. The 3-D corneal model was generated using raw topographic data. Deviation of anterior (Dapexant) and posterior (Dapexpost) apex and minimum thickness points (Dmctant, Dmctpost), Dapexant-Dapexpost difference, total corneal volume (Vtotal), volumetric distribution (VOLAAP, VOLPAP, and VOLMCT), and percentage of relative volume increase (VOLAAPrel, VOLPAPrel, and VOLMCTrel) between 2 consecutive radii centered to anterior/posterior apex and thinnest point were evaluated.
Results:
Dapexpost and Dapexant-Dapexpost difference were higher in the early and mild KC groups compared to the control group (P < .05). Eyes with early and mild KC had decreased Vtotal compared with the control group (P < .05). Dapexpost, Dapexant-Dapexpost difference, and VOLMCTrel between 1.0 and 1.4 mm diameters had area under receiver operating characteristics curve (AUROC) values over 0.93 in discrimination of early KC from normal.
Conclusions:
This is the first study presenting morphogeometric and volumetric characterization of cornea in pediatric patients with early and mild KC using a 3-D corneal model. Integration of the morphogeometric and volumetric parameters to topography software can add value in early detection of KC in pediatric patients.
