Corneal elevation indices in normal and keratoconic eyes
Accepted 6 March 2006.
Purpose
To determine an index that distinguishes keratoconus and keratoconus-suspect eyes from normal eyes with Orbscan (Bausch & Lomb) corneal elevation maps.
Setting
Department of Ophthalmology, Tan Tock Seng Hospital, Singapore, and iLaser Centre, Island Hospital, Penang, Malaysia.
Methods
In this initial phase of this multicenter nonrandomized retrospective study, 1 eye of 166 normal subjects, 15 keratoconus patients, and 11 keratoconus suspects was examined at 1 clinic. The anterior best-fit sphere (BFS), posterior BFS, anterior elevation, posterior elevation, and maximum and minimum keratometries were analyzed. Two indices with the highest sensitivity and specificity classifying these conditions were identified using receiver operating characteristic curves. These 2 indices were evaluated in a subsequent validation study using 1 eye of 221 normal subjects, 43 keratoconus patients, and 23 keratoconus suspects from another clinic.
Results
The anterior elevation and anterior elevation ratio (anterior elevation ratio = anterior elevation/anterior BFS) best classified the different groups. An anterior elevation ratio of 0.5122 mm or less had 99% sensitivity and 95.2% specificity while a ratio 16.5 μm or less had 80.1% sensitivity and 80.8% specificity in discriminating normal eyes from keratoconus and keratoconus suspects. The results were similar in the validation study. In addition, these anterior elevation and anterior elevation ratio cutoff values had high sensitivity and specificity in identifying keratoconus suspects from normal eyes in the validation study.
Conclusion
Anterior corneal elevation parameters are clinically relevant measures for detecting keratoconus and suspected keratoconus eyes.
From The Eye Institute, Tan Tock Seng Hospital (Fam), Singapore, and the iLaser Centre, Island Hospital (Lim), Penang, Malaysia
Corresponding author: Lim Kooi Ling, iLaser Centre, 308 Macalister Road, 10450 Penang, Malaysia.
Neither author has a financial or proprietary interest in the materials or methods mentioned.
ABSTRACT