ArticleAmerican journal of ophthalmology2025
Epithelial Mapping Efficacy for Subclinical Keratoconus Identification.
Article in American journal of ophthalmology, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 9 papers.
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Who cites it
9 citing papers in PubMed.
- Regional corneal epithelial thickness and asymmetry patterns in early keratoconus versus regular astigmatism using MS-39 anterior segment OCT: a comparative cross-sectional study.BMC ophthalmology · 2026Article
- Motion-Tracking Brillouin Microscopy for Keratoconus Suspect Identification: Comparison With Multimodal Corneal Imaging.American journal of ophthalmology · 2026Article
- Trends in the Management of Keratoconus in Australia.Ophthalmic & physiological optics : the journal of the British College of Ophthalmic Opticians (Optometrists) · 2026Article
- Epithelial thickness gradients as a diagnostic biomarker for early-stage keratoconus.International ophthalmology · 2026Article
- Data-Driven Detection of Subclinical Keratoconus via Semi-Supervised Clustering of Multidimensional Corneal Biomarkers.Ophthalmology science · 2026Article
- Advancing subclinical keratoconus detection using polarization-sensitive optical coherence tomography and artificial intelligence.Biophotonics discovery · 2026Article
- Interventional Keratoconus Management: The Critical Imperative for Early Detection and Treatment.Clinical ophthalmology (Auckland, N.Z.) · 2026Article
- Corneal epithelium is altered in keratoconus and forme fruste keratoconus.Scientific reports · 2025Article
- Brillouin microscopy for focal biomechanical measurements in normal and keratoconic corneas: A narrative review.Survey of ophthalmologyReview
Corrections and comments
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Authors and funding
7 authors.
Funding
Abstract
purposeTo evaluate the utility of automated epithelial thickness metrics to identify subclinical keratoconus (SKC) through epithelial thickness pattern comparisons between normal controls, (SKC), and manifest keratoconus (KC).
designRetrospective cross-sectional study.
methodsThere were 200 eyes from 200 patients evaluated, including: (1) 100 control eyes from 100 patients with bilaterally normal corneal topography/tomography and slit-lamp examination (controls); (2) 50 eyes from 50 patients with SKC; (3) 50 eyes from 50 patients with KC. Epithelial mapping was performed using anterior segment optical coherence tomography (AS-OCT) imaging (Avanti RTVue XR, Optovue). Area under the receiver operating characteristic (AUROC) curves were used to determine the overall discriminative accuracy of the significant test parameters as described by the area under the curve (AUC) and to calculate the sensitivity and specificity of each parameter.
resultsThere were no differences between control and SKC groups in any regional OCT epithelial thickness parameter. Among relational epithelial thickness metrics, only superonasal - inferotemporal (SN-IT) value differences reached statistical significance between control and SKC groups (-0.81 μm versus 0.41 μm), but this metric still showed limited performance in differentiating groups (AUROC = 0.68). Most stromal thickness values were significantly different between SKC and controls.
conclusionEpithelial thickness patterns were not effective as a primary metric to identify subclinical keratoconus. Scheimpflug metrics and regional stromal thickness values significantly outperformed epithelial metrics in differentiating both SKC and KC eyes from controls. Epithelial mapping metrics thus appear significantly less sensitive than predicted for subclinical keratoconus detection in early disease manifestations.
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