{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,20]],"date-time":"2026-08-20T20:58:40Z","timestamp":1787259520484,"version":"build-2736575974"},"reference-count":29,"publisher":"MDPI AG","issue":"9","license":[{"start":{"date-parts":[[2024,9,20]],"date-time":"2024-09-20T00:00:00Z","timestamp":1726790400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Life"],"abstract":"<jats:p>Synopsis: Corneal epithelial wavefront error and epithelial thickness variance qualify as highly sensitive and specific biomarkers for epithelial basement membrane dystrophy (EBMD). The biomarkers show a normalization after treatment of EBMD with phototherapeutic keratectomy. Purpose: To gauge the diagnostic value of epithelial basement membrane dystrophy (EBMD), a novel spectral-domain optical coherence tomography (SD-OCT)-based imaging modality for simultaneous morphological (thickness profile) and refractive (optical wavefront) assessment of the corneal epithelial layer in one of the most common but often underdiagnosed corneal dystrophies. Methods: In this prospective observational study, a total of 32 eyes of 32 patients diagnosed with EBMD and 32 eyes of 32 healthy control subjects were examined with high-resolution anterior segment SD-OCT (MS-39; CSO, Florence, Italy). Various epithelial thickness and epithelial wavefront-derived terms were compared between groups and receiver operating characteristic (ROC) curves were computed to analyze the diagnostic capacity of the respective parameters. A total of 17 of 32 EBMD patients underwent treatment with phototherapeutic keratectomy (PTK) and were followed up for 3 months. Results: Epithelial thickness variance (60.4 \u00b1 56.7 \u00b5m versus 7.6 \u00b1 6.1 \u00b5m) and interquartile range (11.0 \u00b1 6.9 versus 3.3 \u00b1 1.9 \u00b5m) were markedly elevated in EBMD patients as compared with healthy controls (both with p &lt; 0.001). Epithelial wavefront analysis showed a highly statistically significant excess in all examined aberration terms in EBMD patients (all with p &lt; 0.001). Significantly greater areas under the curve (AUCs) were yielded by the epithelial wavefront-derived parameters (e.g., total epithelial wavefront error: AUC = 0.966; 95% confidence interval (CI) 0.932\u20131) than by the epithelial thickness-derived parameters (e.g., variance: AUC = 0.919; 95% CI 0.848\u20130.990). Conclusions: Corneal epithelial wavefront aberrometry proved valuable as an objective biomarker for EBMD, with high sensitivity and specificity. PTK resulted in a reduction of morphological and refractive epithelial irregularities in EBMD.<\/jats:p>","DOI":"10.3390\/life14091188","type":"journal-article","created":{"date-parts":[[2024,9,20]],"date-time":"2024-09-20T07:38:57Z","timestamp":1726817937000},"page":"1188","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":2,"title":["Corneal Epithelial Wavefront Error as a Novel Diagnostic Marker for Epithelial Basement Membrane Dystrophy"],"prefix":"10.3390","volume":"14","author":[{"given":"Vitus","family":"Grauvogl","sequence":"first","affiliation":[{"name":"Department of Ophthalmology, UK Augsburg, Stenglinstrasse, 86156 Augsburg, Germany"},{"name":"Department of Ophthalmology, LMU Klinikum, Mathildenstrasse, 80336 Munich, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8891-4875","authenticated-orcid":false,"given":"Wolfgang","family":"Mayer","sequence":"additional","affiliation":[{"name":"Department of Ophthalmology, LMU Klinikum, Mathildenstrasse, 80336 Munich, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0279-4823","authenticated-orcid":false,"given":"Jakob","family":"Siedlecki","sequence":"additional","affiliation":[{"name":"Department of Ophthalmology, LMU Klinikum, Mathildenstrasse, 80336 Munich, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9908-5205","authenticated-orcid":false,"given":"Niklas","family":"Mohr","sequence":"additional","affiliation":[{"name":"Department of Ophthalmology, LMU Klinikum, Mathildenstrasse, 80336 Munich, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Martin","family":"Dirisamer","sequence":"additional","affiliation":[{"name":"Department of Ophthalmology, LMU Klinikum, Mathildenstrasse, 80336 Munich, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5580-612X","authenticated-orcid":false,"given":"Siegfried","family":"Priglinger","sequence":"additional","affiliation":[{"name":"Department of Ophthalmology, LMU Klinikum, Mathildenstrasse, 80336 Munich, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0707-9551","authenticated-orcid":false,"given":"Stefan","family":"Kassumeh","sequence":"additional","affiliation":[{"name":"Department of Ophthalmology, LMU Klinikum, Mathildenstrasse, 80336 Munich, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7815-6289","authenticated-orcid":false,"given":"Nikolaus","family":"Luft","sequence":"additional","affiliation":[{"name":"Department of Ophthalmology, LMU Klinikum, Mathildenstrasse, 80336 Munich, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2024,9,20]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"466","DOI":"10.1097\/ICO.0000000000003420","article-title":"IC3D Classification of Corneal Dystrophies-Edition 3","volume":"43","author":"Weiss","year":"2024","journal-title":"Cornea"},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1159\/000324074","article-title":"IC3D classification of corneal dystrophies","volume":"48","author":"Weiss","year":"2011","journal-title":"Dev. 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