Background
Keratoconus (KC) is a noninflammatory disease causing anatomical deformity of the cornea and is manifested by marked conical protrusion in addition to thinning of the corneal central part. There are currently no standardized screening criteria for KC, making early diagnosis difficult. Early diagnosis aids in stopping progression and better management. It has been proposed that spectral domain optical coherence tomography (SD-OCT) has a diagnostic advantage in the early detection of corneal thickness changes in early KC.

Aim
Detection of corneal epithelial thickness changes in early KC eyes versus normal eyes using SD-OCT.

Methods
The research involved 30 eyes with early KC and 30 eyes from healthy control patients. Both groups underwent detailed ophthalmological examination and measurement of regional corneal epithelial thickness with anterior segment SD-OCT.

Results
In the cases group, corneal epithelium thickness decreased significantly in all regions tested. Additionally, all parameters of the pentacam pachymetry indices showed a statistically significant increase in the cases group. All of the thinnest pachymetry at central 5 mm and 7 mm Area Under the Curve (AUC=0.822 and 0.804), the location Y at central 5 mm and 7 mm (AUC=0.796 and 0.738), the minimum-maximum at central 5 mm and 7 mm (AUC=0.878 and 0.934), and the standard of deviation at central 5 mm and 7 mm (AUC=0.935 and 0.941) showed a statistically significant predictive value for differentiation KC cases from control (P < 0.001), with the highest AUC reported with the standard of deviation. The tested corneal thickness in various regions correlated positively and statistically significantly with pentacam pachymetry indices.

Conclusions
Early KC is associated with corneal thinning and increased pentacam pachymetry index parameters. The changes detected by pentacam pachymetry and epithelial thickness as detected by SD-OCT showed a significant correlation.