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Comparison of corneal epithelial and stromal thickness distributions between eyes with keratoconus and healthy eyes with corneal astigmatism ? 2.0 D.

ABSTRACT: To identify corneal epithelial- and stromal-thickness distribution patterns in keratoconus using spectral-domain optical coherence tomography (SD-OCT).We analyzed SD-OCT findings in 20 confirmed cases of keratoconus (group 1) and in 20 healthy subjects with corneal astigmatism ? 2 D (group 2). Epithelial and stromal thicknesses were measured at 11 strategic locations along the steepest and flattest meridians, previously located by corneal topography. Vertical mirrored symmetry superimposition was used in the statistical analysis.The mean maximum keratometry measurements in groups 1 and 2 were 47.9 ± 2.9 D (range, 41.8-52.8) and 45.6 ± 1.1 D (range, 42.3-47.5), respectively, with mean corneal cylinders of 3.3 ± 2.2 D (range, 0.5-9.5) and 3.6 ± 1.2 D (range, 2.0-6.4), respectively. The mean epithelial thickness along the steepest meridian in group 1 was the lowest (37.4 ± 4.4 µm) at 1.2 mm inferotemporally and the highest (59.3 ± 4.4 µm) at 1.4 mm supranasally from the corneal vertex. There was only a small deviation in thickness along the steepest meridian in group 2, as well as along the flattest meridians in both groups. The stromal thickness distribution in the two groups was similar to the epithelial, while the stromal thickness was generally lower in group 1 than in group 2.SD-OCT provides details about the distribution of corneal epithelial and stromal thicknesses. The epithelium and stroma in keratoconic eyes were thinner inferotemporally and thicker supranasally compared with control eyes. The distribution pattern was more distinct in epithelium than in stroma. This finding may help improve the early diagnosis of keratoconus.ClinicalTrials.gov NCT02023619.

SUBMITTER: Zhou W

PROVIDER: S-EPMC3904857 | biostudies-literature | 2014

REPOSITORIES: biostudies-literature

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Comparison of corneal epithelial and stromal thickness distributions between eyes with keratoconus and healthy eyes with corneal astigmatism ≥ 2.0 D.

Zhou Wen W Stojanovic Aleksandar A

PloS one 20140128 1

<h4>Purpose</h4>To identify corneal epithelial- and stromal-thickness distribution patterns in keratoconus using spectral-domain optical coherence tomography (SD-OCT).<h4>Patients and methods</h4>We analyzed SD-OCT findings in 20 confirmed cases of keratoconus (group 1) and in 20 healthy subjects with corneal astigmatism ≥ 2 D (group 2). Epithelial and stromal thicknesses were measured at 11 strategic locations along the steepest and flattest meridians, previously located by corneal topography. ...[more]

PMID: 24489687

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Project description:ObjectiveTo map the corneal epithelial thickness with Fourier-domain optical coherence tomography (OCT) and to develop epithelial thickness-based variables for keratoconus detection.DesignCross-sectional observational study.ParticipantsOne hundred forty-five eyes from 76 normal subjects and 35 keratoconic eyes from 22 patients.MethodsA 26,000-Hz Fourier-domain OCT system with 5-?m axial resolution was used. The cornea was imaged with a Pachymetry + Cpwr scan pattern (6-mm scan diameter, 8 radials, 1024 axial-scans each, repeated 5 times) centered on the pupil. Three scans were obtained at a single visit in a prospective study. A computer algorithm was developed to map the corneal epithelial thickness automatically. Zonal epithelial thicknesses and 5 diagnostic variables, including minimum, superior-inferior (S-I), minimum-maximum (MIN-MAX), map standard deviation (MSD), and pattern standard deviation (PSD), were calculated. Repeatability of the measurements was assessed by the pooled standard deviation. The area under the receiver operating characteristic curve (AUC) was used to evaluate diagnostic accuracy.Main outcome measuresDescriptive statistics, repeatability, and AUC of the zonal epithelial thickness and diagnostic variables.ResultsThe central, superior, and inferior epithelial thickness averages were 52.3 ± 3.6 ?m, 49.6 ± 3.5 ?m, and 51.2 ± 3.4 ?m in normal eyes and 51.9 ± 5.3 ?m, 51.2 ± 4.2 ?m, and 49.1 ± 4.3 ?m in keratoconic eyes. Compared with normal eyes, keratoconic eyes had significantly lower inferior (P = 0.03) and minimum (P<0.0001) corneal epithelial thickness, greater S-I (P = 0.013), more negative MIN-MAX (P<0.0001), greater MSD (P<0.0001), and larger PSD (P<0.0001). The repeatability of the zonal average, minimum, S-I, and MIN-MAX epithelial thickness variables were between 0.7 and 1.9 ?m. The repeatability of MSD was better than 0.4 ?m. The repeatability of PSD was 0.02 or better. Among all epithelial thickness-based variables investigated, PSD provided the best diagnostic power (AUC = 1.00). Using an PSD cutoff value of 0.057 alone gave 100% specificity and 100% sensitivity.ConclusionsHigh-resolution Fourier-domain OCT mapped corneal epithelial thickness with good repeatability in both normal and keratoconic eyes. Keratoconus was characterized by apical epithelial thinning. The resulting deviation from the normal epithelial pattern could be detected with very high accuracy using the PSD variable.Financial disclosure(s)Proprietary or commercial disclosure may be found after the references.

Dataset Information

Comparison of corneal epithelial and stromal thickness distributions between eyes with keratoconus and healthy eyes with corneal astigmatism ? 2.0 D.

Publications

Comparison of corneal epithelial and stromal thickness distributions between eyes with keratoconus and healthy eyes with corneal astigmatism ≥ 2.0 D.

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