Three-Dimensional Morphogeometric and Volumetric Characterization of Cornea in Pediatric Patients With Early Keratoconus.

Purpose: To present morphogeometric and volumetric characteristics of the cornea and its diagnostic value in pediatric patients with keratoconus (KC) using 3-dimensional (3-D) corneal modeling.

Design: Cross-sectional study.

Methods: This single-center (VISSUM Innovation, Alicante, Spain) study comprised 49 eyes of 49 pediatric patients (age ≤16 years) with KC and 31 eyes of 31 healthy pediatric controls. Eyes were graded as early (n = 21) and mild KC (n = 28) based on the RETICS (Thematic Network for Co-Operative Research in Health) classification system. The 3-D corneal model was generated using raw topographic data. Deviation of anterior (D) and posterior (D) apex and minimum thickness points (D, D), D-D difference, total corneal volume (V), volumetric distribution (VOL, VOL, and VOL), and percentage of relative volume increase (VOL, VOL, and VOL) between 2 consecutive radii centered to anterior/posterior apex and thinnest point were evaluated.

Results: D and D-D difference were higher in the early and mild KC groups compared to the control group (P < .05). Eyes with early and mild KC had decreased V compared with the control group (P < .05). D, D-D difference, and VOL between 1.0 and 1.4 mm diameters had area under receiver operating characteristics curve (AUROC) values over 0.93 in discrimination of early KC from normal.

Conclusions: This is the first study presenting morphogeometric and volumetric characterization of cornea in pediatric patients with early and mild KC using a 3-D corneal model. Integration of the morphogeometric and volumetric parameters to topography software can add value in early detection of KC in pediatric patients.