摘要
Background:To assess the diagnostic ability of Pentacam HR(Oculus Optikgerate,GmbH,Wetzlar,Germany)tomographic indices in discriminating keratoconus(KC)and KC suspect(KCS)in 10-to 30-year-old patients with Down syndrome(DS).Methods:In this study,DS patients were enrolled through special needs schools,the National Down Syndrome Society,and relevant non-profit organizations.Diagnoses were made independently by two experienced specialists.Forty Pentacam indices related to corneal thickness,volume,density,keratometry,power,shape,aberration,and elevation were extracted.For each index,the accuracy for KC and KCS diagnosis was evaluated using discriminant analysis and the area under receiver operating characteristic curve(AUROC).From each enrolled case,data from onlyoneeyewas entered intheanalyses.Results:Analyses were performed on data from 25 KC,46 KCS,and 154 non-ectatic DS eyes.The best discriminants for KC were anterior higher-order aberrations(HOA)(cutoff>0.643μm,AUROC=0.879),posterior vertical coma(cutoff>0.0702μm,AUROC=0.875),anterior vertical coma(cutoff>0.4124μm,AUROC=0.868),and total HOA(cutoff>0.608μm,AUROC=0.867).The difference between AUROCs were not statistically significant(all P>0.05).For KCS,the best discriminants were minimum corneal thickness(cutoff≤480.0μm,AUROC=0.775),corneal volume(cutoff≤55.3μm,AUROC=0.727)and Belin Ambrosio display-total deviation(BAD-D)(cutoff>2.23,AUROC=0.718)with no significant difference between AUROCs(all P>0.05).Conclusions:In this sample of DS patients,the best KC discriminators were HOA and coma which showed good diagnostic ability.For KCS,the best predictors were minimum corneal thickness,corneal volume,and BAD-D with relatively good diagnostic ability.Defining a new set of KC diagnostic criteria for DS patients is suggested.
