Three-Dimensional Morphogeometric and Volumetric Characterization of Cornea in Pediatric Patients With Early Keratoconus.

Abstract

PURPOSE: To present morphogeometric and volumetric characteristics of the cornea and its diagnostic value in pediatric patients with keratoconus (KC) using 3-dimensional (3-D) corneal modeling. DESIGN: Cross-sectional study. METHODS: This single-center (VISSUM Innovation, Alicante, Spain) study comprised 49 eyes of 49 pediatric patients (age ≤16 years) with KC and 31 eyes of 31 healthy pediatric controls. Eyes were graded as early (n = 21) and mild KC (n = 28) based on the RETICS (Thematic Network for Co-Operative Research in Health) classification system. The 3-D corneal model was generated using raw topographic data. Deviation of anterior (D(apexant)) and posterior (D(apexpost)) apex and minimum thickness points (D(mctant), D(mctpost)), D(apexant)-D(apexpost) difference, total corneal volume (V(total)), volumetric distribution (VOL(AAP), VOL(PAP), and VOL(MCT)), and percentage of relative volume increase (VOL(AAPrel), VOL(PAPrel), and VOL(MCTrel)) between 2 consecutive radii centered to anterior/posterior apex and thinnest point were evaluated. RESULTS: D(apexpost) and D(apexant)-D(apexpost) difference were higher in the early and mild KC groups compared to the control group (P < .05). Eyes with early and mild KC had decreased V(total) compared with the control group (P < .05). D(apexpost), D(apexant)-D(apexpost) difference, and VOL(MCTrel) between 1.0 and 1.4 mm diameters had area under receiver operating characteristics curve (AUROC) values over 0.93 in discrimination of early KC from normal. CONCLUSIONS: This is the first study presenting morphogeometric and volumetric characterization of cornea in pediatric patients with early and mild KC using a 3-D corneal model. Integration of the morphogeometric and volumetric parameters to topography software can add value in early detection of KC in pediatric patients.