{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,10,11]],"date-time":"2025-10-11T01:22:52Z","timestamp":1760145772206,"version":"build-2065373602"},"reference-count":30,"publisher":"MDPI AG","issue":"17","license":[{"start":{"date-parts":[[2024,9,2]],"date-time":"2024-09-02T00:00:00Z","timestamp":1725235200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Diagnostics"],"abstract":"<jats:p>The study aimed to evaluate the precision of different Pentacam indices in diagnosing keratoconus (KC) in pediatric patients with and without Down Syndrome (DS) and determine suitable cutoff values. This prospective multicenter cross-sectional study evaluated 216 eyes of 131 patients aged 6\u201318 years (mean age 12.5 \u00b1 3.2 years) using Pentacam. Patients were categorized into four groups: KC, forme fruste keratoconus (FK), DS, and control, excluding DS patients with topographic KC. Receiver operating characteristic curves were generated to determine the optimal cutoff points and compare the accuracy in identifying KC and FK in patients with and without DS. In DS patients, corneal morphology resembled KC features. The most effective indices for distinguishing KC in DS patients were the average pachymetric progression index (AUC = 0.961), higher-order aberration of the anterior cornea (AUC = 0.953), anterior elevation (AUC = 0.946), posterior elevation (AUC = 0.947), index of vertical asymmetry (AUC = 0.943), and Belin\/Ambrosio enhanced ectasia total derivation value (AUC = 0.941). None of the indices showed good accuracy for distinguishing FK in DS patients. The thresholds of these indices differed significantly from non-DS patients. The results highlighted the need for DS-specific cutoff values to avoid false-positive or false-negative diagnoses in this population.<\/jats:p>","DOI":"10.3390\/diagnostics14171932","type":"journal-article","created":{"date-parts":[[2024,9,2]],"date-time":"2024-09-02T06:51:17Z","timestamp":1725259877000},"page":"1932","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Scheimpflug Tomographic Indices for Classifying Normal, Down Syndrome and Clinical Keratoconus in Pediatric Patients"],"prefix":"10.3390","volume":"14","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-5194-9660","authenticated-orcid":false,"given":"Renato","family":"Souza Oliveira","sequence":"first","affiliation":[{"name":"Instituto Brasileiro de Oftalmologia\u2014IBOL, Rio de Janeiro 22250-145, Brazil"},{"name":"Faculty of Medicine, University of Coimbra, 3004-504 Coimbra, Portugal"},{"name":"Department of Ophthalmology and Visual Sciences, Paulista School of Medicine, Federal University of S\u00e3o Paulo\u2014UNIFESP, Botucatu Street, 822 Vila Clementino, S\u00e3o Paulo 04023-062, Brazil"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9032-1008","authenticated-orcid":false,"given":"Jo\u00e3o Quadrado","family":"Gil","sequence":"additional","affiliation":[{"name":"Faculty of Medicine, University of Coimbra, 3004-504 Coimbra, Portugal"},{"name":"Centro de Responsabilidade Integrado de Oftalmologia, Centro Hospitalar e Universit\u00e1rio de Coimbra, 3004-504 Coimbra, Portugal"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Andreia","family":"Rosa","sequence":"additional","affiliation":[{"name":"Faculty of Medicine, University of Coimbra, 3004-504 Coimbra, Portugal"},{"name":"Centro de Responsabilidade Integrado de Oftalmologia, Centro Hospitalar e Universit\u00e1rio de Coimbra, 3004-504 Coimbra, Portugal"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5881-9161","authenticated-orcid":false,"given":"Maria Jo\u00e3o","family":"Quadrado","sequence":"additional","affiliation":[{"name":"Faculty of Medicine, University of Coimbra, 3004-504 Coimbra, Portugal"},{"name":"Centro de Responsabilidade Integrado de Oftalmologia, Centro Hospitalar e Universit\u00e1rio de Coimbra, 3004-504 Coimbra, Portugal"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Mauro","family":"Campos","sequence":"additional","affiliation":[{"name":"Department of Ophthalmology and Visual Sciences, Paulista School of Medicine, Federal University of S\u00e3o Paulo\u2014UNIFESP, Botucatu Street, 822 Vila Clementino, S\u00e3o Paulo 04023-062, Brazil"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1968","published-online":{"date-parts":[[2024,9,2]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"2257","DOI":"10.1007\/s10792-017-0699-8","article-title":"Pediatric keratoconus: A review of the literature","volume":"38","author":"Mukhtar","year":"2018","journal-title":"Int. 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