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. 2023 Nov 15;23(1):459.
doi: 10.1186/s12886-023-03215-6.

Corneal biomechanics in normal and subclinical keratoconus eyes

Alireza Peyman  1 , Fatemeh Sepahvand  2 , Mohsen Pourazizi  1 , Pegah Noorshargh  1 , Ali Forouhari  3
Affiliations

Corneal biomechanics in normal and subclinical keratoconus eyes

Alireza Peyman et al. BMC Ophthalmol. .

Abstract

Background: The diagnosis of keratoconus, as the most prevalent corneal ectatic disorder, at the subclinical stage gained great attention due to the increased acceptance of refractive surgeries. This study aimed to assess the pattern of the corneal biomechanical properties derived from Corneal Visualization Scheimpflug Technology (Corvis ST) and evaluate the diagnostic value of these parameters in distinguishing subclinical keratoconus (SKC) from normal eyes.

Methods: This prospective study was conducted on 73 SKC and 69 normal eyes. Subclinical keratoconus eyes were defined as corneas with no clinical evidence of keratoconus and suspicious topographic and tomographic features. Following a complete ophthalmic examination, topographic and tomographic corneal assessment via Pentacam HR, and corneal biomechanical evaluation utilizing Corvis ST were done.

Results: Subclinical keratoconus eyes presented significantly higher Deformation Amplitude (DA) ratio, Tomographic Biomechanical Index (TBI), and Corvis Biomechanical Index (CBI) rates than the control group. Conversely, Ambrósio Relational Thickness to the Horizontal profile (ARTh), and Stiffness Parameter at the first Applanation (SPA1) showed significantly lower rates in SKC eyes. In diagnosing SKC from normal eyes, TBI (AUC: 0.858, Cut-off value: > 0.33, Youden index: 0.55), ARTh (AUC: 0.813, Cut-off value: ≤ 488.1, Youden index: 0.58), and CBI (AUC: 0.804, Cut-off value: > 0.47, Youden index: 0.49) appeared as good indicators.

Conclusions: TBI, CBI, and ARTh parameters could be valuable in distinguishing SKC eyes from normal ones.

Keywords: Corneal biomechanics; Corvis ST; Scheimpflug technology; Subclinical keratoconus.

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Conflict of interest statement

The authors declare no competing interests.

Figures

Fig. 1
Fig. 1
Biomechanical/Tomographic output of Corvis ST. a Normal participant, b Subclinical keratoconus case
Fig. 2
Fig. 2
Receiver-Operating Characteristic (ROC) curves. a ARTh, b CBI, c TBI, d DA ratio, e SPA1, f Comparisons of the parameters
Fig. 3
Fig. 3
Scatter plot of Corvis ST parameters and CCT (Red circles: Subclinical keratoconus, Blue circles: Normal)
See this image and copyright information in PMC

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