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ABS TRACT Objective: To determine the sensitivity and specifity of main parameters; maximum keratometry readings (Kmax), pachymetry at the thinnest point of the cornea (TCT), and posterior elevation (PE) in discriminating mild-moderate keratoconus (KC) from severe keratoconus. Material and Methods: Eighty six (51 mild-moderate, and 35 severe) keratoconic patients were recruited in this study. Kmax, TCT, and PE were recorded using Scheimpflug camera system. In order to distinguish mild-moderate KC group from severe KC group, receiver operating characteristic (ROC) curves were generated and areas under the curves (AUC) were calculated for all parameters. Cut off points for Kmax, TCT and PE and sensitivity and specificity, positive likelihood ratio (LR+), and negative likelihood ratio (LR-) for these cut off points were also calculated. Results: Between the severe KC and mild-moderate KC, the most discriminating parameter was Kmax (AUC = 0.913), followed by TCT (AUC = 0.848) and PE (AUC = 0.566). The cut off value was 66.70 D for Kmax with a sensitivity of 88.6% and a specificity of 78.4%. The cut off value was 359.50 μm for TCT with a sensitivity of 80.0% and a specificity of 74.5%. And the cut off value of PE was 171.50 μm with a sensitivity of 54.3% and a specificity of 62.7%. When KC became severe the diagnostic efficiency of characteristic parameters decreased from the Kmax, TCT to PE. Conclusion: In our study, ROC curve analyses indicated that Kmax and TCT were the most important measurements with Pentacam in progression from mild-moderate to severe keratoconus.

Sensitivity and Specifificity of Main Parameters of Corneal Topography for Discriminating the Severity of Keratoconus