Anterior Segment Optical Coherence Tomography: Assisted Topographic Corneal Epithelial Thickness Distribution Imaging of a Keratoconus Patient

Purpose: To evaluate safety, efficacy and ease of measurement of epithelial thickness in a keratoconic patient based on anterior segment optical coherence tomography (AS-OCT). Methods: A 25-year-old male patient, previously diagnosed with keratoconus, with highly asymmetric manifestation among the two eyes, was subjected to AS-OCT corneal epithelial imaging. We investigated epithelial thickness and epithelial topographic thickness distribution. Results: Mean epithelial thickness was 51.97 +/- 0.70 for the less affected right eye (OD), and 55.65 +/- 1.22 for the more affected left eye (OS). Topographic epithelial thickness variability for the OD was 1.53 +/- 0.21 mu m, while for the OS it was 9.80 +/- 0.41 mu m. Conclusions: This case further supports our previous findings with high-frequency ultrasound measurements of the increase in overall epithelial thickness in keratoconic eyes in comparison with normal eyes. AS-OCT further offers ease of use and possibly higher predictability of measurement. This case report, based on AS-OCT imaging, verifies increased overall epithelial thickness in keratoconic eyes, as introduced by a previous study [Kanellopoulos et al.: Clin Ophthalmol 2012;6:789-800], based on high-frequency scanning ultrasound biomicroscopy imaging.