PURPOSE To verify the diagnostic power of vertical and horizontal thickness profiles of the corneal sublayers generated by ultra-high resolution optical coherence tomography (UHROCT) in subclinical and suspected keratoconus. METHODS In this cross-sectional study, 25 eyes with confirmed keratoconus, 63 eyes with suspected keratoconus, 15 eyes with subclinical keratoconus, and 42 normal eyes were investigated. Vertical and horizontal thickness profiles of the corneal epithelium, Bowman's layer, and stroma were measured by UHR-OCT. Diagnostic indices included ratios of thickness distribution and multimeric discriminant functions calculated by multiple logistic regression based on them. Receiver operating characteristic curves were used to verify the predictive accuracy by the area under the curve (AUC). RESULTS Function consisting of two indices (vertical maximum ectasia index of epithelium and horizontal maximum ectasia index of Bowman's layer) performed well to discriminate subclinical keratoconus (AUC = 0.967) and suspected keratoconus (AUC = 0.932) from normal. In addition, when four indices were combined, the diagnostic power for subclinical keratoconus (AUC = 0.984) and suspected keratoconus (AUC = 0.971) was further increased. However, both binary and quaternary functions could not adequately discriminate suspected from subclinical keratoconus. CONCLUSIONS UHR-OCT-generated thickness indices from the vertical and horizontal thickness profiles of the corneal epithelium and Bowman's layer showed an evident diagnostic efficacy in discriminating suspected and subclinical keratoconus from normal eyes. The early changes in keratoconus might prefer thickness distribution in corneal sublayers rather than corneal thickness or topography. [J Refract Surg. 2021;37(7):438-445.].

中文翻译：

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UHR-OCT 生成的用于疑似和亚临床圆锥角膜诊断的角膜垂直和水平厚度剖面。

目的 验证由超高分辨率光学相干断层扫描 (UHROCT) 生成的角膜亚层的垂直和水平厚度剖面对亚临床和疑似圆锥角膜的诊断能力。方法 在这项横断面研究中，对确诊圆锥角膜 25 只眼、疑似圆锥角膜 63 只眼、亚临床圆锥角膜 15 只眼和 42 只正常眼进行了调查。通过 UHR-OCT 测量角膜上皮、鲍曼层和基质的垂直和水平厚度分布。诊断指标包括厚度分布比和基于它们的多元逻辑回归计算的多聚体判别函数。接受者操作特征曲线用于通过曲线下面积（AUC）来验证预测准确性。结果 由两个指数（上皮垂直最大扩张指数和鲍曼层水平最大扩张指数）组成的函数在区分亚临床圆锥角膜 (AUC = 0.967) 和疑似圆锥角膜 (AUC = 0.932) 与正常情况方面表现良好。此外，当四个指标结合时，对亚临床圆锥角膜（AUC = 0.984）和疑似圆锥角膜（AUC = 0.971）的诊断能力进一步提高。然而，二元和四元功能都不能充分区分疑似亚临床圆锥角膜。结论来自角膜上皮和鲍曼层的垂直和水平厚度分布的 UHR-OCT 生成的厚度指数在区分疑似和亚临床圆锥角膜与正常眼睛方面显示出明显的诊断功效。圆锥角膜的早期变化可能更喜欢角膜亚层的厚度分布，而不是角膜厚度或地形。[J 屈光手术。2021;37(7):438-445.]。