Objectives:To evaluate tomographic and topographic parameters in subclinical and clinical keratoconus eyes by comparing them with normal eyes in a young Caucasian population.Materials and Methods:This cross-sectional study included 88 normal eyes (control group), bilateral data from the preclinical stage of 24 progressive keratoconus eyes (bilateral subclinical keratoconus group), 40 fellow eyes of patients with unilateral keratoconus (fellow eyes group) and 97 eyes with mild keratoconus (clinical keratoconus group). Topographic and tomographic data, data from enhanced elevation maps and keratoconus indices were measured in all study eyes using Scheimpflug tomography. Receiver operating characteristic (ROC) curve analysis was used to assess individual parameters to discriminate eyes of patients with subclinical and clinical keratoconus from control eyes. The sensitivity and specificity of the main effective parameters were evaluated and optimal cut-off points were identified to differentiate subclinical keratoconus and keratoconus from normal corneas.Results:Comparison of all subclinical and clinical keratoconus eyes from the normal group revealed significant differences in most diagnostic parameters. The ROC curve analysis showed high overall predictive accuracy of several Pentacam parameters (overall D value, anterior and posterior elevations and difference elevations, pachymetry progression index, index of surface variance, index of height decentration and keratoconus index) in discriminating ectatic corneas from normal ones. These outcomes were proportionally less pronounced in all subclinical keratoconus eyes than in the clinical keratoconus eyes. Pachymetric readings were progressively lower in the bilateral subclinical keratoconus eyes and sensitivity and specificity of the analyzed tomographic and topographic parameters were higher than the fellow eyes group when differentiating subclinical keratoconus from healthy corneas.Conclusion:Scheimpflug tomography parameters such as D value, elevation parameters, progression index and several surface indices can effectively differentiate keratoconus from normal corneas in a Caucasian population. Nevertheless, a combination of different data is required to distinguish subclinical keratoconus.

PurposeTo compare the keratometric and pachymetric parameters of healthy eyes with those affected by steep cornea and keratoconus (KC) using Scheimpflug camera.SettingBriz-L Eye Clinic, Baku, Azerbaijan.DesignA cross-sectional study.MethodsIn this study, 49 KC (Amsler–Krumeich stage 1) eyes and 36 healthy eyes were enrolled. A complete ophthalmic evaluation and a Scheimpflug camera scan were performed in every eye included in the study. Tomographic parameters such as parameters from the front and back cornea, maximum keratometry reading (Kmax), corneal volume (CV), anterior chamber volume (ChV), anterior chamber depth (ACD), anterior chamber angle (AC angle), keratometric power deviation (KPD), maximum front elevation (Max FE), and maximum back elevation (Max BE), as well as pachymetric progression indices (PPI), Ambrosio relational thickness (ART), index of surface variance (ISV), index of vertical asymmetry (IVA), center keratoconus index (CKI), index of height asymmetry (IHA), index of height decentration (IHD), and radius minimum (RM) were collected and statistically compared between the two groups.ResultsPPI, ART, ISV, IVA, CKI, IHA, IHD, and RM parameter values were significantly different (P<0.05) between the KC and healthy eyes. There were no significant differences in K mean and Q values of the frontal corneal parameters, as well as in Kmax, AC angle, RM, back, and front astigmatism, between stage 1 keratoconic and normal Caucasian eyes with steep cornea. All other parameters such as K mean and Q values of the back corneal parameters, Max FE, Max BE, ACD, ChV, and CV showed significant differences between the groups (P<0.05 for all).ConclusionScheimpflug imaging is able to detect corneal morphological differences between stage 1 KC eyes and healthy eyes with steep cornea, in Caucasians.