Evaluation of Corneal Tomographic, Biomechanical and Pachymetric Characteristics in Patients With Keratoconus, Their First-Degree Relatives, and Normal Individuals

Abstract

Purpose: – This study assessed corneal tomographic, biomechanical, and pachymetry using 3 multimodal imaging (MMI) diagnostic capabilitiesto detect keratoconus in first-degree relatives (FDR) of patients with keratoconus and normal populations.Methods: – This was a prospective cross-sectional study. A total of 118 eyes from 78 patients with keratoconus, 96 eyes from 54 FDR subjects, and 126 eyes from 63 healthy individuals were analyzed using the Oculus Pentacam HR, Oculus Corvis ST, and Cirrus OCTA 5000. Corneal tomography, biomechanics, and pachymetry were performed and compared between the 3 groups.Results: – Notable disparities in corneal tomography, biomechanics, and pachymetry were observed between FDR and healthy subjects. FDR exhibited a thinner cornea and reduced corneal biomechanical strength compared with normal eyes. In distinguishing keratoconus in FDR, the diagnostic capabilities of B.Ele.Th (back elevation at thinnest), BAD (Belin/Ambrósio Enhanced Ectasia Display), and TBI (tomographic biomechanics index) proved to be highly effective with area under the curve (AUC) beyond 0.90. Stepwise logistic regression (SLR) model combination of corneal tomography and biomechanics of IHD, CBI, and TBI showed an excellent accuracy of AUC:0.999 for detecting keratoconus in FDR than using single MMI alone.Conclusions: – FDR with keratoconus indeed have an increased likelihood of developing corneal ectasia, including keratoconus itself. MMI screening of asymptomatic relatives can facilitate early stage or subclinical keratoconus detection.