Diagnostic value of corneal optical densitometry in keratoconus

To investigate the clinical significance of the correlation between optical densitometry and both biomechanical and morphological parameters in keratoconus (KC) and to verify the diagnostic value of optical densitometry in KC.

This cross-sectional study included 436 eyes of 295 patients with KC. Corneal optical densitometry, morphological parameters and biomechanical parameters were measured. Spearman's correlation analysis was employed to investigate the association between optical densitometry and both biomechanical and morphological parameters.

Optical densitometry of the anterior (0–2 mm and 2–6 mm), central (0–2 mm), posterior (2–6 mm) and total (2–6 mm) layers correlated positively with SPA1, while the posterior layer (0–2 mm) correlated negatively. Optical densitometry of the anterior layers 2–6 mm, 6–10 mm, and the central layer 6–10 mm negatively affected AL1, while the posterior layer 0–2 mm positively affected it. Optical densitometry of the anterior, central, and posterior layers 0–2 mm and 2–6 mm positively influenced the morphological parameters K₁^F, K₂^F, K_m^F and the absolute values of K₁^B, K₂^B, K_m^B. Optical densitometry of the center (0–2 mm) and posterior (2–6 mm) layers negatively influenced TCT. Optical densitometry of the anterior (0–2 mm and 2–6 mm), center (0–2 mm), posterior (2–6 mm) and total (2–6 mm) layers correlated positively with ACE and PCE, whereas the posterior layer (0–2 mm) correlated negatively.

Optical densitometry was correlated with biomechanical and morphological parameters in keratoconus, suggesting its potential as a diagnostic indicator for assessing keratoconus progression and treatment efficacy.