ESCRS - PP02.02 - Epithelial Versus Biomechanical Parameters Discriminating Between Normal, Keratoconus, Subclinical, And Forme Fruste Keratoconus Eyes

Epithelial Versus Biomechanical Parameters Discriminating Between Normal, Keratoconus, Subclinical, And Forme Fruste Keratoconus Eyes

Published 2025 - 43rd Congress of the ESCRS

Reference: PP02.02 | Type: Free paper | DOI: 10.82333/zxhg-qy58

Authors: Dr.Harika Reddy* 1

1Ophthalmology,Bharathi Hospital,Kadapa,India

Purpose

To compare the discriminative power of epithelial versus biomechanical parameters between normal and Keratoconus (KC) eyes.

Setting

Research Department at Ofttalmosalud, Instituto de Ojos, Lima, Peru.

Methods

Prospective cohort study including 205 eyes (60 normal, 30 subclinical (SKC), 8 forme fruste keratoconus (FFKC), and 107 keratoconus (KC). Parameters from Placido+AS OCT (MS-39) were evaluated, including epithelial data and the corneal biomechanics index (Corvis ST) and the Pentacam, among them Notable points spread (NPS), Ectasia index Front (EIf), Ectasia index posterior (EIp), Symmetry index front (SIf), Symmetry index posterior (Sip), Epithelial thickness maximum (ETmax), stromal thickness minimum (StrThikMin), EpiTI (epithelial thickness Increase), TImax (thickness increase maximum),  CBI, TBI, BAD-D, SP-A1, DA-ratio, SSI y ART. The AUROC, sensitivity, and specificity were obtained for the variables with statistical significance
 

Results

There were statistically significant differences between normal and KC eyes for all corneal epithelial and biomechanical indexes (p<.001). When assessing normal and subclinical KC, statistical differences were found for Slf, Slp, Elf, Elp, StrThikMin, and NPS coming from the MS-39 device and for CBI, TBI, BAD-D, ARTh, Integrated Radius, DAratio, and SSI from the Corvis and Pentacam. The CBI (AUROC 0.855, sensitivity 0.86, specificity 0.81, cutoff 0.31) presents the higher AUROC value discriminating between normal and SCK eyes. The SPA1 (AUROC 0.85, sensitivity 0.87, specificity 0.70, cutoff 0.19) presents the higher AUROC value discriminating between FFKC and normal eyes.
 

Conclusions

Biomechanical data showed higher discriminatory power than epithelial data when discriminating normal from subclinical keratoconus eyes. Normal and Keratoconus eyes present with significant differences in epithelial and biomechanical parameters.