Sensitivity and Specificity of Belin Ambrosio Enhanced Ectasia Display in Early Diagnosis of Keratoconus

PURPOSE: Early diagnosis of keratoconus disease (KCN) is the first priority in the preoperative evaluations of refractive surgery (RS).The aim of this study was to investigate the correlation between findings of Belin Ambrosio enhanced ectasia display (BAD) software and conventional corneal imaging (Orbscan and topography) in the early diagnosis of KCN. METHODS: For conducting this cross-sectional study, a total of 1000 eyes were selected from 500 patients that underwent the myopic photorefractive keratectomy surgery and were compared in four study groups during the years 2017–2018. In group 1, all topography, Orbscan, and BAD criteria were normal (65.8%).In contrast, in Group 2, at least one of the topography or Orbscan criteria as well as at least one BAD criterion (12.6%) were abnormal. In Group 3, the eyes had normal Orbscan and topography criteria with at least one abnormal BAD criterion (18.5%). Also, in Group 4, the patients had at least one abnormal Orbscan or topography criterion, but all BAD criteria (3.1%) were normal. Thickness of the thinnest point (TP) of cornea was compared in Pentacam and topography. Data analysis was done by SPSS software (version 21). RESULTS: BAD criteria were normal in 78.5% of all eyes with normal topography and Orbscan criteria (specificity). BAD criteria were also abnormal in 80.2% of eyes (sensitivity). There was also no significant difference between TP in Orbscan and Pentacam. CONCLUSIONS: BAD criteria had a relatively acceptable sensitivity and specificity, compared with conventional Orbscan and topography criteria. Thus, BAD criteria can be more effective in the early diagnosis of KCN.