A new approach to keratoconus detection based on corneal morphogeometric analysis.

<h4>Purpose</h4>To characterize corneal structural changes in keratoconus using a new morphogeometric approach and to evaluate its potential diagnostic ability.<h4>Methods</h4>Comparative study including 464 eyes of 464 patients (age, 16 and 72 years) divided into two groups:...

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Main Authors: Francisco Cavas-Martínez, Laurent Bataille, Daniel G Fernández-Pacheco, Francisco J F Cañavate, Jorge L Alió
Format: Article
Language:English
Published: Public Library of Science (PLoS) 2017-01-01
Series:PLoS ONE
Online Access:https://journals.plos.org/plosone/article/file?id=10.1371/journal.pone.0184569&type=printable
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Summary:<h4>Purpose</h4>To characterize corneal structural changes in keratoconus using a new morphogeometric approach and to evaluate its potential diagnostic ability.<h4>Methods</h4>Comparative study including 464 eyes of 464 patients (age, 16 and 72 years) divided into two groups: control group (143 healthy eyes) and keratoconus group (321 keratoconus eyes). Topographic information (Sirius, CSO, Italy) was processed with SolidWorks v2012 and a solid model representing the geometry of each cornea was generated. The following parameters were defined: anterior (Aant) and posterior (Apost) corneal surface areas, area of the cornea within the sagittal plane passing through the Z axis and the apex (Aapexant, Aapexpost) and minimum thickness points (Amctant, Amctpost) of the anterior and posterior corneal surfaces, and average distance from the Z axis to the apex (Dapexant, Dapexpost) and minimum thickness points (Dmctant, Dmctpost) of both corneal surfaces.<h4>Results</h4>Significant differences among control and keratoconus group were found in Aapexant, Aapexpost, Amctant, Amctpost, Dapexant, Dapexpost (all p<0.001), Apost (p = 0.014), and Dmctpost (p = 0.035). Significant correlations in keratoconus group were found between Aant and Apost (r = 0.836), Amctant and Amctpost (r = 0.983), and Dmctant and Dmctpost (r = 0.954, all p<0.001). A logistic regression analysis revealed that the detection of keratoconus grade I (Amsler Krumeich) was related to Apost, Atot, Aapexant, Amctant, Amctpost, Dapexpost, Dmctant and Dmctpost (Hosmer-Lemeshow: p>0.05, R2 Nagelkerke: 0.926). The overall percentage of cases correctly classified by the model was 97.30%.<h4>Conclusions</h4>Our morphogeometric approach based on the analysis of the cornea as a solid is useful for the characterization and detection of keratoconus.
ISSN:1932-6203