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Is epithelial thickness mapping a reliable tool in forme fruste keratoconus?

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Session Details

Session Title: Moderated Poster Session: Cornea

Venue: Poster Village: Pod 1

First Author: : A.Swampillai UK

Co Author(s): :    K. O'Kane   N. Habib                    

Abstract Details


Epithelial thickness profile across the cornea and in the thinnest corneal zone has been claimed as a useful tool for the early diagnosis of corneal ectasia. Here we present five cases of form fruste keratoconus with near normal epithelial thickness mapping with optical coherence tomography (OCT).


Royal Eye Infirmary, Plymouth, UK.


Retrospective case review of five cases of established keratoconus in one eye with the form fruste condition in the other eye. All eyes were assessed using a rotating Scheimpflug camera (Pentacam) and a Fourier-domain OCT system (RTVue) utilising a “Pachymetry + Cpwr” corneal scan pattern (6mm diameter, 8 radials, 1024 axial-scans each repeated 5 times) centring on the pupil. Zonal epithelial thickness and other diagnostic variables, including pachymetry statistics (within 5mm zone) and epithelium statistics (within 5mm zone including superior-inferior, minimum-maximum, standard deviation) were analysed.


In all five patients, normal epithelial thickness was noted within the central 2mm zone (average 54 µm +/-1) in the form fruste corneas. Near normal epithelial thickness was also noted in the thinnest corneal zone (average 51-53 µ). In contrast to previous studies, the thinnest epithelial point was not found to be consistently located inferiorly.


Epithelial thickness mapping in the thinnest corneal zone may not always be a reliable indicator of early form fruste keratoconus.

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