Forme Fruste Keratoconus Imaging and Validation via Novel Multi-Spot Reflection Topography

BACKGROUND/AIMS This case report aims to evaluate safety, efficacy and applicability of anterior surface imaging in a patient with forme fruste keratoconus (FFKC) based on a novel multi-spot, multicolor light-emitting-diode (LED) tear film-reflection imaging technology. CASE DESCRIPTION A 45-year-old male patient, clinically diagnosed with FFKC, with highly asymmetric manifestation between his eyes, was subjected to the multicolor-spot reflection topography. We investigated elevation and sagittal curvature maps comparatively with the multicolor-spot reflection topographer, a Placido topographer and a Scheimpflug imaging system. For the right eye, steep and flat keratometry values were 41.92 and 41.05 D with the multicolor spot-reflection topographer, 42.30 and 42.08 D with the Placido, and 41.95 and 41.19 D with the Scheimpflug system. For the left eye, steep and flat keratometry values were 41.86 and 41.19 D with the multicolor spot-reflection topographer, 42.06 and 41.66 D with the Placido topographer, and 41.96 and 41.66 D with the Scheimpflug camera. Average repeatability of the keratometry measurements was ±0.35 D for the multicolor spot-reflection topographer, ±0.30 D for the Placido, and ±0.25 D for the Scheimpflug camera. Very good agreement between the instruments was demonstrated on the elevation and curvature maps. CONCLUSION The ease of use and the comparable results offered by the multicolor spot-reflection topographer, in comparison to established Placido and Scheimpflug imaging, as well as the increased predictability that may be offered by the multicolor spot-reflection topographer, may hold promise for wider clinical application, such as screening of young adults for early keratoconus and, in a much wider perspective, potential candidates for laser corneal refractive surgery.