Corneal tomographic and densitometric characteristics in children with allergic conjunctivitis: a comparative pentacam AXL study

PURPOSE: To explore corneal tomographic and densitometric parameters associated with subtle corneal alterations in children with allergic conjunctivitis using the Pentacam AXL system. METHODS: This cross-sectional study included 64 eyes of 32 children with allergic conjunctivitis (Group 1) and 40 eyes of 20 age- and sex-matched healthy controls (Group 2). Only participants with spherical equivalent between + 4.00 and - 4.00 diopters and cylindrical values up to - 2.00 D were included to minimize refractive bias. Corneal keratometric, pachymetric, elevation, ectasia, densitometric, and asphericity (Q value) parameters were obtained using the Pentacam AXL (OCULUS Inc., Germany). Data were analyzed using IBM SPSS Statistics 28.0 (IBM Corp., Chicago, IL, USA), and p < 0.05 was considered statistically significant. RESULTS: No significant differences were found between groups in age, sex, intraocular pressure, keratometric parameters (K1, K2, Kmax), pachymetry, or elevation indices (p > 0.05). Ectasia indices including ISV, IVA, KI, and CKI were comparable. However, the mean Q value was significantly more negative in the allergic group (p = 0.03). Corneal densitometry values were also significantly higher across most corneal zones, indicating early microstructural alterations possibly related to allergic inflammation. CONCLUSION: Children with allergic conjunctivitis demonstrate subtle but measurable differences in corneal asphericity and corneal densitometry. These parameters may represent promising complementary indicators for the assessment of early corneal alterations in pediatric ocular allergy. Longitudinal studies are needed to clarify their clinical relevance and temporal behavior.