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

Abstract

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. Cross-sectional study. 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. 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. 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.