Evaluation of corneal and lens densitometry using Scheimpflug tomography in neurofibromatosis type 1 patients without clinical ocular involvement

INTRODUCTION: This cross-sectional study evaluated corneal and lens densitometry in adult patients with neurofibromatosis type 1 (NF-1) without overt ophthalmic manifestations on routine clinical examination using Scheimpflug imaging. METHODS: Thirty newly diagnosed NF-1 patients aged 18-50 years and 30 age- and sex-matched healthy controls were included. Participants underwent corneal and lens densitometry measurements using the Pentacam HR (Oculus, Wetzlar, Germany). Corneal densitometry was assessed in concentric zones and depth layers, while lens densitometry was measured after pharmacologic pupil dilation. RESULTS: While topographic parameters K1, K2, K-mean, and K-max were significantly higher in the NF-1 group, iridocorneal angle values were lower (p < 0.05). Corneal densitometry showed significantly higher values in anterior (10-12), central (2-6, 6-10 and 10-12 mm), posterior (0-2, 2-6 and total), total (6-10, 10-12 mm) zones in NF-1 patients (all p < 0.05). Lens densitometry (LD-mean, LD-sd and LD-max) was significantly increased in the NF-1 group (all p < 0.05). DISCUSSION: Our findings suggest that NF-1 patients may exhibit regional increases in corneal light scatter and increased lens densitometry, even in the absence of clinically apparent ocular involvement. These results are exploratory and support further studies aimed at evaluating imaging-based approaches to understand ocular involvement in NF-1.