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Published on: October 21, 2022
Epithelial thickness ratio: a quantitative OCT-based metric for characterizing epithelial remodelling in keratoconus
Kelly Ann Hutchinson1, Lauren Breslin2, Mary Holdsworth3
1PGY-3 Ophthalmology, Department of Ophthalmology Queen's University, Kingston, ON.
Summary
The epithelial thickness ratio (ETR) effectively distinguishes keratoconus from normal eyes. This optical coherence tomography (OCT)-derived metric shows promise for diagnosing corneal ectasia.
Area of Science:
- Ophthalmology
- Corneal Imaging
- Biomedical Optics
Background:
- Keratoconus is a progressive corneal ectasia.
- Accurate diagnosis is crucial for management and preventing vision loss.
- Novel imaging biomarkers are needed for early detection.
Purpose of the Study:
- To develop and validate the epithelial thickness ratio (ETR) using optical coherence tomography (OCT).
- To assess ETR's ability to differentiate keratoconus from normal eyes.
Main Methods:
- Retrospective chart review of 27 normal eyes and 18 keratoconus eyes.
- Calculated ETR by comparing peripheral to central epithelial thickness at various radii.
- Assessed diagnostic performance using receiver operating characteristic (ROC) curve analysis.
Main Results:
- All ETR configurations were significantly higher in keratoconus eyes (p ≤ .0002).
- Area under the ROC (AUROC) curve values ranged from 0.813 to 0.879.
- The 8-point, 2.0-mm radius ETR configuration showed the highest AUROC (0.879).
Conclusions:
- ETR effectively differentiates clinically diagnosed keratoconus from normal corneas.
- ETR shows potential as an objective measure of ectasia-related epithelial changes.
- Further prospective studies are needed for validation in subclinical cases and refractive surgery screening.
