title: Keratoconus diagnosis with optical coherence  tomography–based pachymetric scoring system.
abstract: OBJECTIVE
  To develop an optical coherence tomography (OCT) pachymetry map–based keratoconus risk scoring system.
  
  
  METHODS
  Doheny Eye Institute, University of Southern California, Los Angeles, California, and Brass Eye Center, New York, New York, USA; Department of Ophthalmology, Affiliated Eye Hospital of Wenzhou Medical College, Wenzhou, China.
  
  
  METHODS
  Cross-sectional study.
  
  
  METHODS
  Fourier-domain OCT was used to acquire corneal pachymetry maps in normal and keratoconus subjects. Pachymetric variables were minimum, minimum−median, superior–inferior (S–I), superonasal–inferotemporal (SN–IT), and the vertical location of the thinnest cornea (Ymin). A logistic regression formula and a scoring system were developed based on these variables. Keratoconus diagnostic accuracy was measured by the area under the receiver operating characteristic (ROC) curve.
  
  
  RESULTS
  One hundred thirty-three eyes of 67 normal subjects and 82 eyes from 52 keratoconus subjects were recruited. The keratoconus logistic regression formula = 0.543 × minimum + 0.541 × (S–I) − 0.886 × (SN–IT) + 0.886 × (minimum–median) + 0.0198 × Ymin. The formula gave better diagnostic power with the area under the ROC than the best single variable (formula = 0.975, minimum = 0.942; P<.01). The diagnostic power with the area under the ROC of the keratoconus risk score (0.949) was similar to that of the formula (P=.08).
  
  
  CONCLUSIONS
  The OCT corneal pachymetry map–based logistic regression formula and the keratoconus risk scoring system provided high accuracy in keratoconus detection. These methods may be useful in keratoconus screening.
authors.forename: Bing
authors.initials: B
authors.lastname: Qin
authors.forename: Shihao
authors.initials: S
authors.lastname: Chen
authors.forename: Robert
authors.initials: R
authors.lastname: Brass
authors.forename: Yan
authors.initials: Y
authors.lastname: Li
authors.forename: Maolong
authors.initials: M
authors.lastname: Tang
authors.forename: Xinbo
authors.initials: X
authors.lastname: Zhang
authors.forename: Xiaoyu
authors.initials: X
authors.lastname: Wang
authors.forename: Qinmei
authors.initials: Q
authors.lastname: Wang
authors.forename: David
authors.initials: D
authors.lastname: Huang
mesh_terms: D000293:Adolescent; D000328:Adult; D003315:Cornea / Q000473:pathology*; D063171:Corneal Pachymetry; D003430:Cross-Sectional Studies; D005260:Female; D005583:Fourier Analysis; D006801:Humans; D007640:Keratoconus / Q000175:diagnosis*; D008297:Male; D008875:Middle Aged; D012372:ROC Curve; D015203:Reproducibility of Results; D041623:Tomography, Optical Coherence; D055815:Young Adult