Abstract:AIM: To explore the value of corneal epithelial thickness parameters in the diagnosis of early keratoconus by Fourier domain optical coherence tomography(FD-OCT).
METHODS: Retrospective control study. Patients with early keratoconus who were admitted to the Department of Ophthalmology of the First Affiliated Hospital of Soochow University from January 2015 to October 2020 and patients who received laser refractive surgery for myopia during the same period were included in this study. Using FD-OCT to measure the cornea in circle centralized by the pupil and with diameter of 9mm in the early-keratoconus group and the control group. This was to obtain the thickness parameter of corneal epithelium with diameter of 7mm, the respective averaged thickness value of corneal epithelium and the respective averaged thickness value of the full corneal layer on each of the 25 divisions. The parameter value differences between the early-keratoconus group and the control group were compared, and the diagnosis value of parameters that hold difference was analyzed.
RESULTS: The Min-e value in early-keratoconus group was significantly lower than that of the control group. On contrary, the value of Std.Dev, Max-Min-e, and Max-e were significantly higher in early-keratoconus group than that in latter one(all P<0.001). The value of Std.Dev and Max-Min-e hold a greater diagnostic efficiency on diagnosis of early keratoconus(AUC=0.937, 0.928), while Max -e value and Min-e value performed a medium diagnostic efficiency(AUC=0.871, 0.797). Analysis on thickness of corneal epithelium on the 25 divisions found that the thickness of corneal epithelium at infratemporal region of inner ring(EIT1)became thinner most obviously in early-keratoconus group, with greatest diagnostic efficiency(AUC=0.827). The average corneal thickness of the 25 zones of the early keratoconus group was significantly thinner than that in the normal control group. Averaged corneal thickness at infratemporal region of inner ring(CIT1)hold a relatively high diagnostic efficiency among the 25 divisions(AUC=0.903).
CONCLUSION: The parameter values of corneal epithelium thickness including Std.Dev, Max-Min-e, Max-e, Min-e, the averaged thickness value of corneal epithelium at infratemporal region of inner ring, and the thickness value of full corneal layer at infratemporal region of inner ring can all be used for diagnosis of early keratoconus.
