Purpose: To assess anterior segment parameters of eyes with keratoconus (KC) at different clinical stages of disease.
Methods: KC and non-KC patients were recruited from public and private clinics in Melbourne, Australia. Axial length (AL), mean front corneal curvature (Front Km), mean back corneal curvature (Back Km), central corneal thickness (CCT), corneal thickness at the apex (CTA), corneal thickness at the thinnest point (CTT), anterior chamber depth (ACD), and corneal volume were noted for all the eyes.
Results: A total of 181 individuals comprising 44 (24.3%) subclinical KC, 118 (65.2%) clinical KC, and 19 (10.5%) control subjects were analyzed. Significant differences were noticed between the subclinical KC and control group for ACD and CTT, whereas between clinical and control groups, significant differences were obtained for AL, CCT, CTA, CTT, and ACD (p < 0.05). In the case of mild, moderate, and severe KC groups, Back Km, CCT, CTA, and CTT were significantly associated (p < 0.001) with increasing disease severity. We further did receiver operating characteristic analysis to confirm the importance of pachymetric parameters in differentiating between control and KC eyes. The area under the receiver operating characteristic curve value of CTT for subclinical and clinical KC was 0.68 and 0.82, which showed that it may be a potential marker for the early detection and prevention of KC.
Conclusions: This study identified the anterior chamber parameters that differ between subclinical and clinical KC as well as the severity of KC. There is a significant reduction in CTT between control and subclinical eyes, although there are no significant alterations in Front and Back Km or AL between the two groups. Also, a progressive reduction in the pachymetric readings at the pupil center, apex, and thinnest corneal point was identified when comparing mild to severe KC groups. Thus, corneal thickness represents an important parameter that needs to be considered in monitoring KC disease severity.