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Epithelial Mapping Efficacy for Subclinical Keratoconus Identification.

Barbara A L Dutra1, Bassel Hammoud2, Bianca N Susanna3

  • 1From the Cleveland Clinic (B.A.D., B.H., B.N.S., L.A., W.J.D., J.B.R.), Cole Eye Institute, Cleveland, Ohio, USA; Department of Ophthalmology (B.A.D., B.N.S.), University of Sao Paulo, Sao Paulo, Brazil.

American Journal of Ophthalmology
|March 8, 2025
PubMed
Summary
This summary is machine-generated.

Automated epithelial thickness mapping is not effective for identifying subclinical keratoconus (SKC). Stromal thickness measurements are more sensitive for detecting early signs of keratoconus (KC) in patients.

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Area of Science:

  • Ophthalmology
  • Corneal Imaging
  • Disease Detection

Background:

  • Subclinical keratoconus (SKC) represents an early stage of keratoconus (KC).
  • Accurate detection of SKC is crucial for timely intervention and preventing vision loss.
  • Current diagnostic methods may have limitations in identifying early disease stages.

Purpose of the Study:

  • To assess the diagnostic utility of automated epithelial thickness metrics.
  • To compare epithelial thickness patterns in normal controls, SKC, and manifest KC.
  • To determine if epithelial mapping can identify subclinical keratoconus.

Main Methods:

  • Retrospective cross-sectional study of 200 eyes (100 controls, 50 SKC, 50 KC).
  • Epithelial mapping using anterior segment optical coherence tomography (AS-OCT).
  • Analysis of epithelial thickness patterns and comparison with stromal thickness and Scheimpflug metrics.

Main Results:

  • No significant differences in regional epithelial thickness between control and SKC groups.
  • Superonasal-inferotemporal epithelial thickness difference showed limited discriminative ability (AUROC=0.68).
  • Stromal thickness values were significantly different between SKC and control groups.

Conclusions:

  • Epithelial thickness patterns are ineffective as a primary metric for identifying subclinical keratoconus.
  • Stromal thickness measurements and Scheimpflug metrics significantly outperform epithelial metrics for SKC detection.
  • Epithelial mapping shows limited sensitivity for early keratoconus detection.