Analysis of corneal wavefront aberrations and corneal densitometry in eyes with epithelial basement membrane dystrophy.

PURPOSE: To investigate wavefront aberrations, as well as corneal optical densitometry (COD), in eyes with epithelial basement membrane dystrophy (EBMD) and the influence on visual acuity.

METHODS

In this cross-sectional study, 70 eyes of 70 patients (mean age 55.9 ± 14.0 years) with the central cornea involving EBMD were compared to 50 healthy eyes of 50 patients (mean age 58.8 ± 14.1 years) serving as controls. Wavefront aberrations of the anterior corneal surface and the total cornea were measured with the Pentacam AXL (Oculus Optikgeräte GmbH, Wetzlar, Germany), and calculated for the 6 mm central corneal zone. In addition, the COD (corneal light backscatter measured in grey scale units) of the anterior 120 µm of the central 0-2 mm, 2-6 mm, and 6-10 mm of the cornea was evaluated. Corrected distance visual acuity (CDVA) was correlated with wavefront aberrations and COD using Spearman correlation analysis.

RESULTS

EBMD resulted in significant higher peak-to-valley (PTV; median: 15.0 [interquartile range: 9] µm), square root of the sum of the squared higher-order aberrations (RMS-HOA; 0.77 [0.52] µm), astigmatism (1.06 [1.04] µm), coma (0.41 [0.44] µm), and trefoil (0.28 [0.40] µm) (all p ≤ 0.01). A moderate correlation was found especially between CDVA and PTV as well as RMS-HOA. EBMD led to a statistically significant higher COD (p < 0.01) in the central corneal 6-mm and correlated moderately with CDVA outcomes.

CONCLUSIONS

Our study revealed a significant correlation between elevated wavefront aberrations and backscattering in eyes affected by epithelial basement membrane dystrophy. While COD demonstrates potential for diagnostic purposes, additional studies are necessary to ascertain its specificity and distinguish EBMD from other ocular surface disorders.