title: A Novel scoring system for distinguishing keratoconus from normal eyes.
abstract: OBJECTIVE
  To evaluate the accuracy of a novel scoring system in differentiation of keratoconus (KC) eyes from normal eyes using a Scheimpflug camera system tomography.
  
  
  METHODS
  Marmara University Hospital, Istanbul, Turkey and Birinci Eye Hospital, Istanbul, Turkey.
  
  
  METHODS
  Retrospective case-control study.
  
  
  METHODS
  The study included 624 keratoconus eyes and 512 healthy eyes. Thirty nine significant parameters obtained from the Scheimpflug imaging system (Pentacam-Oculus Optikgeräte GmbH, Wetzlar, Germany) were studied. The cut-off value and area under receiver operating characteristic (AUROC) curve analysis for each studied parameter were established in the previous study. Minus three and plus three standard deviations of the cut-off value were scored after multiplication of AUROC for each parameter. The sum of all scores (TKS; Total Keratoconus Score) was compared between keratoconus and normal eyes.
  
  
  RESULTS
  Average TKS value was -29.57±5.65 (Range from -43.11 to -7.09) in normal eyes and 36.23±24.3 (Range from -16.82 to 97.45) in keratoconus eyes (p<0.001). Receiver operating characteristic curve analyses showed perfect predictive accuracy for TKS (ROC 1.0 (95% CI: 0.999-1.0)). The TKS distinguished the keratoconus group from the normal group with 99% sensitivity and 99% specificity at the best cut-off point of -12.45.
  
  
  CONCLUSIONS
  The new scoring system measured by the Scheimpflug imaging system provides perfect discrimination of keratoconus from normal corneas.
authors.affiliation: Birinci Eye Hospital, Istanbul, Turkey. Electronic address: forucoglu@faikorucoglu.com.
authors.forename: Faik
authors.initials: F
authors.lastname: Oruçoğlu
authors.affiliation: Marmara University, School of Medicine, Department of Ophthalmology, Istanbul, Turkey.
authors.forename: Ebru
authors.initials: E
authors.lastname: Toker
mesh_terms: D000293:Adolescent; D000328:Adult; D000465:Algorithms; D019781:Corneal Topography / Q000379:methods*; D003937:Diagnosis, Differential; D005260:Female; D006801:Humans; D007090:Image Interpretation, Computer-Assisted / Q000379:methods*; D021621:Imaging, Three-Dimensional / Q000379:methods*; D007640:Keratoconus / Q000175:diagnosis*; D008297:Male; D008875:Middle Aged; D012016:Reference Values; D015203:Reproducibility of Results; D012680:Sensitivity and Specificity; D055815:Young Adult
keywords: Cornea; Keratoconus; Scheimpflug imaging system