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Corneal ectasia detection by epithelial pattern standard deviation from OCT.

Marcella Q Salomão1, Ana Luisa Hofling-Lima, Louise Pellegrino Gomes Esporcatte

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Journal of Cataract and Refractive Surgery
|October 6, 2022
PubMed
Summary
This summary is machine-generated.

Corneal epithelial pattern standard deviation (PSD) effectively distinguishes normal corneas from ectatic conditions like keratoconus (KC). This method accurately detects epithelial thickness changes, even in early stages of KC.

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Area of Science:

  • Ophthalmology
  • Corneal Imaging
  • Biometry

Background:

  • Corneal ectatic conditions, such as keratoconus (KC), are characterized by progressive thinning and steepening of the cornea.
  • Early and accurate diagnosis of corneal ectasia is crucial for timely intervention and management to prevent vision loss.
  • Current diagnostic methods may have limitations in detecting subtle or early-stage ectatic changes.

Purpose of the Study:

  • To evaluate the efficacy of corneal epithelial pattern standard deviation (PSD) in differentiating normal corneas from those with ectatic conditions.
  • To assess the diagnostic accuracy of epithelial PSD in identifying keratoconus (KC) and very asymmetric ectasia (VAE).

Main Methods:

  • A cross-sectional retrospective study involving 4 groups: normal corneas (N), keratoconus (KC), very asymmetric ectasia with ectasia (VAE-E), and very asymmetric ectasia with normal topography in the fellow eye (VAE-NT).
  • Corneal tomography (Pentacam), OCT imaging (RT Vue), and biomechanical assessment (Corvis ST) were performed.
  • Corneal epithelial thickness maps were analyzed to calculate the epithelial PSD, and receiver operating characteristic (ROC) curve analysis was used to determine diagnostic accuracy.

Main Results:

  • Epithelial PSD showed significant differences across all four groups (P < .0001).
  • Normal corneas had significantly lower epithelial PSD values compared to KC and VAE-E groups (P < .0001) and the VAE-NT group (P = .0008).
  • While no significant difference was found between KC and VAE-E groups (P = .4284), both showed significantly higher PSD values than the VAE-NT group.

Conclusions:

  • Corneal epithelial pattern standard deviation (PSD) is a valuable tool for detecting abnormal epithelial thickness patterns.
  • Epithelial PSD accurately identifies corneal ectasia, including keratoconus (KC), even in its subclinical or early forms (form fruste).
  • This index aids in distinguishing between normal and ectatic corneas, potentially improving diagnostic capabilities.