Purpose: To evaluate the use of Scheimpflug tomography in corneal densitometry (CD) in comparing the stages of keratoconic eyes.
Methods: Keratoconic (KC) corneas (stages 1-3 classified according to the topographic parameters) were examined using the Scheimpflug tomographer (Pentacam, Oculus) using the CD software. CD was measured over three different depths (anterior stromal layer [120 μm], posterior stromal layer [60 μm], and middle stromal layer between these two layers), and concentric annular zones (0.0 to 2.0, 2.0 to 6.0, 6.0 to 10.0, and 10.0 to 12.0 mm diameter area).
Results: The study participants were divided into three groups: keratoconus (KC) stage 1 (KC1) with 64 participants, keratoconus stage 2 (KC2) with 29 participants, and keratoconus stage 3 (KC3) with 36 participants. Comparing CD of all three layers (anterior, central, and posterior) of the cornea over different circular annuli (0-2, 2-6, 6-10, and 10-12 mm) revealed a significant difference in the 6-10 mm annulus between all groups and in all layers (P = 0.3, 0.2, and 0.2, respectively). Area under curve (AUC) was done. It revealed that the central layer showed the highest specificity (93.8%) in comparing KC1 and KC2, whereas CD in the anterior layer between KC2 and KC3 had the highest specificity (86.2%).
Conclusion: CD showed increased values in the anterior corneal layer and in the annulus 6-10 mm more than other locations in all stages of KC.
Keywords: Corneal densitometry; Scheimpflug imaging; keratoconus.