Corneal Densitometry in Keratoconus

Purpose: The aim of this study was to compare corneal densitometry measured by Scheimpflug tomography in normal and keratoconic eyes and to assess the differences in densitometry values among the stages of keratoconus. Methods: Keratoconic and normal corneas were examined using the Pentacam. Corneal densitometry was measured over a 12-mm diameter area, divided by annular concentric zones and depths. Keratoconus was classified according to the topographic keratoconus classification. Results: We enrolled 1 eye randomly selected from each of 172 patients with normal corneas (N) and 98 patients with bilateral keratoconus (KC). There were significant differences between the groups for densitometry measurements in 2 annuli: central 2.0 mm in diameter (N = 16.85 +/- 2.42, KC = 18.93 +/- 2.78, P = 0.0001) and annulus 2.0 to 6.0 mm in diameter (N = 15.18 +/- 2.18, KC = 16.16 +/- 1.71, P = 0.005), and total diameter (N = 24.89 +/- 6.18, KC = 16.71 +/- 2.3, P = 0.033). Divided by layers, the inner parts of anterior (120 mu m), central (from 120 mu m to the last 60 mu m), and posterior (last 60 mu m) layers were also higher in the KC group (P < 0.001). There were differences according to the stages of KC for corneal densitometry of the central annuli at total thickness, anterior and central layers. More advanced cases presented a higher backscatter (P < 0.05). The anterior layer presented the smallest overlap between groups and KC stages. Conclusions: The densitometry map reveals that light backscatter was higher in the central portion of the anterior keratoconic cornea than in the normal cornea. The densitometry level is higher in more advanced stages.