Advanced anterior segment imaging in keratoconus: a review

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  • Akilesh Gokul
    Department of Ophthalmology, New Zealand National Eye Centre, Faculty of Medical and Health Sciences University of Auckland Auckland New Zealand
  • Hans R Vellara
    Department of Ophthalmology, New Zealand National Eye Centre, Faculty of Medical and Health Sciences University of Auckland Auckland New Zealand
  • Dipika V Patel
    Department of Ophthalmology, New Zealand National Eye Centre, Faculty of Medical and Health Sciences University of Auckland Auckland New Zealand

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<jats:title>Abstract</jats:title><jats:p>Advances in anterior segment imaging have enhanced our ability to detect keratoconus in its early stages and characterize the pathologic changes that occur. Computerized corneal tomography has elucidated the alterations in shape of the anterior and posterior corneal surfaces and alterations in thickness as the disease progresses. Automated screening indices such as the keratoconus screening index were developed to assist in detecting keratoconus in suspicious cases. <jats:italic>In vivo</jats:italic> assessment of keratoconic corneas has revealed that compromised corneal biomechanics can now be measured clinically. Optical coherence tomography has demonstrated alterations in corneal epithelial thickness and distribution in keratoconus, has a role in assessing Descemet's membrane detachment in acute corneal hydrops (ACH) and the depth of the demarcation line following corneal collagen cross‐linking. <jats:italic>In vivo</jats:italic> confocal microscopy has exhibited cellular changes that occur in keratoconus and provided insight into cellular events that may be related to the development of neovascularization in ACH.</jats:p>

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