Mapping the Future: Anterior Segment OCT for Corneal Epithelial Thickness in Vernal Keratoconjunctivitis

<b>Objectives:</b> To compare corneal epithelium parameters in between children with vernal keratoconjunctivitis (VKC) and healthy controls with the help of anterior segment optical coherence tomography (OCT). <b>Material and method:</b> Children aged 5 to 18 years with a diagnosis of VKC were included in this study. A total of 216 eyes were included in the study, which were divided into two groups: the case group comprising 108 eyes of VKC patients and the control one comprising 108 eyes of healthy subjects. Central 5 mm cornea was taken into consideration for evaluation of different epithelial thickness parameters using anterior segment OCT. <b>Results:</b>On analysis of the corneal epithelium parameters, the superior quadrant in VKC patients as compared to controls was found to be significantly thinner (38.69 ± 5.91 μm vs 40.98 ± 3.86 μm). Other noteworthy findings were a reduced minimum (MIN) epithelial thickness and a greater negative (MIN-MAX) value in VKC patients as compared to controls. In a detailed study specifically in patients signifiwith mixed VKC, they had epithelial thinning in the superior quadrant and markedly reduced MIN epithelial thickness than the controls. <b>Conclusions:</b> This study demonstrates that children with VKC exhibit notable changes in corneal epithelial thickness parameters, particularly a significant reduction in superior and minimum epithelial thickness compared to healthy controls. Additionally, the significant correlation between epithelial thickness and disease duration suggests that prolonged duration of VKC may exacerbate epithelial thinning. The results underscore the significance of using anterior segment optical coherence tomography as a useful technique for tracking corneal alterations in children with VKC.