Assessment of corneal epithelial thickness map for the early detection of keratoconus

Background Keratoconus (KC) is a progressive disorder of cornea causing thinning, steepening, and decreased visual acuity. Early detection is critical for effective management. Objective To assess the effectiveness of corneal epithelial thickness map of anterior segment optical coherence tomography (AS-OCT) in conjunction with pentacam to distinguish between normal corneas, subclinical KC, and early KC. Patients and methods This is a cross-sectional analytical study that involved 120 eyes divided into 40 eyes with subclinical KC, 40 eyes with early KC, and 40 eyes of healthy patients. Corneal epithelial thickness was analyzed using AS-OCT and ABCD grading parameters of pentacam were analyzed. Results Subclinical KC showed significant epithelial thinning infero-temporally correlating with reduced corneal thickness and increased posterior elevation P less than 0.05 compared with normal patients. There were significant differences in epithelial thickness between normal, subclinical, and early KC groups. Pentacam and AS-OCT improved diagnosis, classification, and the ability to rule out KC in ambiguous cases. Conclusion Epithelial thickness maps obtained by AS-OCT enhance early detection of KC providing valuable additional diagnostic information beyond traditional methods.