Polarimetric interferometry-derived isogyre parameters correlate with keratoconus severity: a retrospective observational study

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Keratoconus involves progressive corneal thinning and stromal collagen disorganization that may precede conventional morphological detection. Polarimetric interferometry captures corneal birefringence related to collagen anisotropy and could serve as a non-invasive structural biomarker. We conducted a retrospective observational study of 95 keratoconus patients and 21 healthy controls who underwent corneal topography (Pentacam) and polarimetric interferometry (Lumaxis). Isogyre cross-pattern parameters, widest arm width, narrowest arm width, arm-width standard deviation, and centration indices (M1, M2), were quantified with GeoGebra and correlated with keratometric values, thinnest corneal thickness, Amsler-Krumeich staging, and Belin-Ambrosio ABCD classification. Widest arm width correlated strongly with Pentacam-derived AK stage (Spearman’s ρ = 0.798, p < 0.0001) and maximum keratometry (ρ = 0.730, p < 0.001), and moderately with thinnest corneal thickness (ρ = −0.488, p < 0.001). Arm-width asymmetry correlated inversely with thinnest corneal thickness (ρ = −0.381, p < 0.001). Receiver operating characteristic analysis showed promising discriminative performance: arm-width standard deviation (AUC 0.95) and widest arm (AUC 0.87) differentiated keratoconus from controls. Multivariable analyses confirmed independence from corneal curvature and thickness. Lumaxis-derived isogyre parameters correlate significantly with established keratoconus severity indices, supporting polarimetric interferometry as a complementary modality for assessing corneal stromal disorganization. Prospective longitudinal studies with automated image analysis are warranted.

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