ESCRS - PO559 - Diagnostic Reliability Between Corneal-Epithelial Oct And Topography For Keratoconus Screening And Diagnosis In Guatemala

Diagnostic Reliability Between Corneal-Epithelial Oct And Topography For Keratoconus Screening And Diagnosis In Guatemala

Published 2025 - 43rd Congress of the ESCRS

Reference: PO559 | Type: Free paper | DOI: 10.82333/n23z-3m24

Authors: Shima Eghtedari 1 , Farhad Nejat* 2

1Biomedical engineering,Vision health research clinic,Tehran,Iran, Islamic Republic Of, 2Ophthalmology,Vision health research clinic,Tehran,Iran, Islamic Republic Of

Purpose

To evaluate the diagnostic accuracy and predictive utility of corneal-epithelial OCT map (OCT-EM) and corneal topography (C-topo) for screening of healthy patients and diagnosis of subclinical and manifest keratoconus patients in a Guatemalan population. To determine the sensitivity and specificity of OCTEM and C-topo

Setting

Unidad Nacional de Oftalmología, Guatemala City, Central America.

Methods

Prospective observational study of patients 12 years of age, undergoing evaluation after clinical suspicion for keratoconus. OCT-EM Cirrus 6000® OCT (Carl Zeiss, Germany) and C-topo with AXL-Pentacam® (Oculus, Germany) was performed. A decision tree was created according to topographic (Kmax, Posterior BFS, Thinnest corneal thickness, RMS High order aberrations) and OCT-EM parameters (pachymetry minimum, SN-IT pachymetry, Min-Max pachymetry and Standard deviation) to classify patients as non-keratoconus, subclinical or manifest keratoconus; based on an expert consensus. Sensitivity and specificity were calculated, with ROC curves plotted and area under de curve (AUC) calculated per diagnostic category according to the decision tree used

Results

One hundred-eight eyes of fifty-four patients were analyzed from April to December 2024. Mean age was 24.1 years (SD± 9.2), 72.22% females. According to the decision tree used, C-topo has the highest sensitivity and specificity for the diagnosis of manifest and subclinical keratoconus while OCT-EM has the highest sensitivity and specificity for the screening of normal corneas. AUC showed similar results. 

Conclusions

Both corneal topography and corneal epithelial OCT map have an important role in the assessment of clinically suspected keratoconus patients; while C-topo seems to be more useful for the diagnosis of manifest and subclinical keratoconus cases and OCT-EM with a paramount performance in the screening of normal corneas; more research is needed to validate this data with a vaster number of patients analyzed