title: Correlation of basic indicators with stages of keratoconus assessed by Pentacam tomography.
abstract: OBJECTIVE
  To evaluate the diagnostic efficiency of basic indicators and find characteristic indicators for keratoconus (KC) at adjacent stages, and to assess the progression pattern of KC.
  
  
  METHODS
  One hundred and eight (41 subclinical, 40 moderate, and 27 severe) keratoconic patients (108 eyes) and 105 myopic patients (105 eyes) as controls were recruited in this prospective, comparative case series study. Pentacam topography was performed. Receiver-operating-characteristic curves were used to get the characteristic indicators.
  
  
  RESULTS
  The most efficient distinguishing index between the subclinical KC and the controls was posterior elevation value (PEV, AUC=0.882), with the highest specificity being 93.8%. Corneal thickness (AUC=0.852) and posterior inferior-superior value (I-S) ranked second and third (AUC=0.776). When KC became moderate, PEV remained to be of the highest diagnostic efficiency (AUC=0.988), followed by the anterior elevation value (AUC=0.986) and other parameters of anterior surface. The diagnostic value increased significantly in the anterior curvature indices (all AUC>0.900) and appeared in the anterior best fitting sphere radius (AUC=0.919) when KC developed into the severe stage.
  
  
  CONCLUSIONS
  In the subclinical stage of KC, PEV, thickness, and posterior I-S had important diagnostic values, and elevation values remained most efficient when KC developed to the moderate stage. The anterior curvature indices were most characteristic when KC became severe. KC first appeared in the inferior cornea of posterior surface, but the feature of protrusion formed at the moderate stage.
authors.affiliation: Qingdao University, Qingdao 266071, Shandong Province, China ; Qingdao Eye Hospital, Shandong Eye Institute, Shandong Academy of Medical Sciences, Qingdao 266071, Shandong Province, China.
authors.forename: Xian-Li
authors.initials: XL
authors.lastname: Du
authors.affiliation: Qingdao Eye Hospital, Shandong Eye Institute, Shandong Academy of Medical Sciences, Qingdao 266071, Shandong Province, China.
authors.forename: Min
authors.initials: M
authors.lastname: Chen
authors.affiliation: Qingdao Eye Hospital, Shandong Eye Institute, Shandong Academy of Medical Sciences, Qingdao 266071, Shandong Province, China.
authors.forename: Li-Xin
authors.initials: LX
authors.lastname: Xie
keywords: Pentacam; diagnostic efficiency; keratoconus; progression pattern; topography