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Comparison of a Scheimpflug imaging with other screening indices in diagnosing keratoconus and keratoconus suspect

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Yan Huo1,4, Ruisi Xie1,4, Xuan Chen1, Shuangcheng Li1, Haohan Zou2,3, Yutong Liu1 &  Yan Wang 1,2,3

1 School of Medicine, Nankai University, Tianjin, China. 

2 Tianjin Key Lab of Ophthalmology and Visual Science,  Tianjin Eye Institute, Tianjin Eye Hospital, Nankai University Affiliated Eye Hospital, Tianjin, China. 

3 Nankai Eye  Institute, Nankai University, No. 4, Gansu Road, Heping District, Tianjin 300020, China. 

4 These authors contributed  equally: Yan Huo and Ruisi Xie. 

email: wangyan7143@vip.sina.com


Keratoconus (KC) is an irreversible blinding eye disease; therefore, early screening of KC suspects (KCS)  is crucial for protecting patients' quality of life. Scheimpflug imaging is a commonly used screening  device in clinical practice. We aimed to evaluate the diagnostic ability of a Scheimpflug imaging device (Scansys) for KC and KCS and compared it with other Scheimpflug-based devices (Pentacam and  Corvis ST). This prospective case-control study included 107 normal eyes, 72 KCS, and 57 KC. Scansys  screening index Keratoconus probability (KCP) showed excellent performance in diagnosing KC at a  cutoff value of 16.4 (area under the receiver operating characteristic [AUROC]=1.000), with 100%  sensitivity and 98.11% specificity. KCP had a better KCS diagnostic ability at a cutoff value of 8.9  (AUROC=0.813) than Corvis biomechanical index (CBI, AUROC=0.764), reaching 67.61% sensitivity  and 85.85% specificity. Pentacam screening index Belin/Ambrósio enhanced ectasia display deviation  (BAD-D) showed the best performance with 92.96% sensitivity and 89.62% specificity at a cutoff value  of 1.525 (AUROC=0.970) in diagnosing KCS. Scansys provides accurate KCP parameters in diagnosing  KC; however, the efficiency of diagnosing KCS should be further optimized.


Yan Huo, et al. Comparison of a Scheimpflug imaging with other screening indices in diagnosing keratoconus and keratoconus suspect.pdf


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