{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,11]],"date-time":"2026-09-11T15:39:52Z","timestamp":1789141192995,"version":"build-2803163510"},"reference-count":42,"publisher":"Public Library of Science (PLoS)","issue":"9","license":[{"start":{"date-parts":[[2022,9,1]],"date-time":"2022-09-01T00:00:00Z","timestamp":1661990400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["www.plosone.org"],"crossmark-restriction":false},"short-container-title":["PLoS ONE"],"abstract":"<jats:sec id=\"sec001\"><jats:title>Purpose<\/jats:title><jats:p>This study aimed to evaluate and compare the discriminating ability of corneal elevation maps generated using a swept-source optical coherence tomography (SS-OCT) (SS-OCT ANTERION, Heidelberg Engineering, Heidelberg, Germany), which was estimated with different reference surfaces, to distinguish normal corneas from those with keratoconus and keratoconus suspect.<\/jats:p><\/jats:sec><jats:sec id=\"sec002\"><jats:title>Methods<\/jats:title><jats:p>A total of 126 eyes of patients, which comprised 43, 37, and 46 keratoconus, keratoconus suspects, and normal controls, respectively, were included in this study. The anterior and posterior elevations at the thinnest point under the best-fit sphere (BFS) and toric-ellipsoid (BFT), respectively, and other corneal parameters were measured using the SS-OCT. In addition, the receiver operating characteristic (ROC) curve analysis and cut-off value were calculated to evaluate the diagnostic ability of the corneal elevation values in differentiating keratoconus and keratoconus suspects from normal eyes.<\/jats:p><\/jats:sec><jats:sec id=\"sec003\"><jats:title>Results<\/jats:title><jats:p>The mean total keratometric and corneal elevation values were significantly higher in the keratoconus group than in the other groups. Pachymetric parameters exhibited the lowest values for keratoconus. In addition, ROC curve analyses showed a high accuracy of the thinnest point anterior and posterior BFT for both keratoconus and keratoconus suspects and normal controls (area under the ROC were 0.969 and 0.961, respectively). Furthermore, the optimal cut-off point of the posterior elevation at the thinnest point under BFT was 16.44 \u03bcm (sensitivity and specificity of 86% and 98%, respectively) for differentiating keratoconus from normal and keratoconus suspect eyes.<\/jats:p><\/jats:sec><jats:sec id=\"sec004\"><jats:title>Conclusions<\/jats:title><jats:p>The elevation map using the BFS and BFT references measured with the anterior segment SS-OCT is considered an effective indicator for keratoconus diagnosis. Therefore, the anterior segment SS-OCT can effectively differentiate keratoconus from suspected keratoconus and normal corneas by measuring parameters such as posterior and anterior elevations, pachymetry, and keratometry.<\/jats:p><\/jats:sec>","DOI":"10.1371\/journal.pone.0274071","type":"journal-article","created":{"date-parts":[[2022,9,1]],"date-time":"2022-09-01T17:44:03Z","timestamp":1662054243000},"page":"e0274071","update-policy":"https:\/\/doi.org\/10.1371\/journal.pone.corrections_policy","source":"Crossref","is-referenced-by-count":18,"title":["Anterior segment characteristics in normal and keratoconus eyes evaluated with a new type of swept-source optical coherence tomography"],"prefix":"10.1371","volume":"17","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-4752-3098","authenticated-orcid":true,"given":"Kook Young","family":"Kim","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Seongjun","family":"Lee","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Young Joon","family":"Jeon","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ji Sang","family":"Min","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"340","published-online":{"date-parts":[[2022,9,1]]},"reference":[{"issue":"4","key":"pone.0274071.ref001","doi-asserted-by":"crossref","first-page":"297","DOI":"10.1016\/S0039-6257(97)00119-7","article-title":"Keratoconus","volume":"42","author":"YS Rabinowitz","year":"1998","journal-title":"Surv Ophthalmol"},{"issue":"2","key":"pone.0274071.ref002","doi-asserted-by":"crossref","first-page":"189","DOI":"10.1038\/eye.2013.278","article-title":"The pathogenesis of keratoconus","volume":"28","author":"A Davidson","year":"2014","journal-title":"Eye"},{"issue":"9","key":"pone.0274071.ref003","doi-asserted-by":"crossref","first-page":"1005","DOI":"10.1001\/jamaophthalmol.2019.2058","article-title":"Genetic variants associated with corneal biomechanical properties and potentially conferring susceptibility to keratoconus in a genome-wide association study","volume":"137","author":"AP Khawaja","year":"2019","journal-title":"JAMA Ophthalmol"},{"key":"pone.0274071.ref004","first-page":"656","article-title":"Increased lacrimal inflammatory mediators in patients with keratoconus","volume":"27","author":"GS Moura","year":"2021","journal-title":"Molecular Vision"},{"key":"pone.0274071.ref005","article-title":"Comprehensive transcriptome analysis of patients with keratoconus highlights the regulation of immune responses and inflammatory processes","volume":"13","author":"X Sun","year":"2022","journal-title":"Front Gen"},{"issue":"1","key":"pone.0274071.ref006","doi-asserted-by":"crossref","first-page":"46","DOI":"10.1111\/cxo.12579","article-title":"Clinical biomicroscopy and retinoscopy findings of keratoconus in a Middle Eastern population","volume":"101","author":"M Naderan","year":"2018","journal-title":"Clin Exp Optom"},{"issue":"9","key":"pone.0274071.ref007","doi-asserted-by":"crossref","first-page":"1213","DOI":"10.1016\/j.jcrs.2017.07.021","article-title":"New perspectives on the detection and progression of keratoconus","volume":"43","author":"A Mart\u00ednez-Abad","year":"2017","journal-title":"J cataract Refract Surg"},{"key":"pone.0274071.ref008","doi-asserted-by":"crossref","first-page":"13","DOI":"10.2147\/OPTO.S63486","article-title":"Strategies for improving the early diagnosis of keratoconus","volume":"8","author":"Y. 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