Corneal Epithelial Wavefront Error as a Novel Diagnostic Marker for Epithelial Basement Membrane Dystrophy

Area of Science:

• Ophthalmology
• Biomarkers
• Corneal Diseases

Background:

• Epithelial basement membrane dystrophy (EBMD) is a common, often underdiagnosed corneal condition.
• Accurate diagnostic tools are needed to identify and manage EBMD.

Purpose of the Study:

• To evaluate the diagnostic value of a novel spectral-domain optical coherence tomography (SD-OCT) imaging modality for EBMD.
• To assess both morphological (thickness) and refractive (wavefront) properties of the corneal epithelium.

Main Methods:

• Prospective observational study comparing 32 EBMD patients with 32 healthy controls using high-resolution anterior segment SD-OCT.
• Analysis of epithelial thickness variance and epithelial wavefront aberrations.
• Receiver operating characteristic (ROC) curve analysis to determine diagnostic capacity.
• Follow-up of 17 EBMD patients treated with phototherapeutic keratectomy (PTK) for 3 months.

Main Results:

• EBMD patients exhibited significantly elevated epithelial thickness variance and interquartile range compared to controls (p < 0.001).
• Epithelial wavefront analysis revealed a significant excess of aberrations in EBMD patients (p < 0.001).
• Epithelial wavefront parameters demonstrated higher diagnostic accuracy (AUC = 0.966) than thickness parameters (AUC = 0.919).

Conclusions:

• Corneal epithelial wavefront aberrometry serves as a sensitive and specific objective biomarker for EBMD.
• Phototherapeutic keratectomy (PTK) effectively reduces both morphological and refractive epithelial irregularities associated with EBMD.