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

Beschi, Giacomo, Pezzagno, Ilaria, Vaccaro, Sabrina, Rovati, Marco, Grezzi, Luca, Semeraro, Francesco, Lipari, Eugenio, Singh, Vivek, Basu, Sayan, Roy, Abhijit Sinha, Joshi, Vineet, Boote, Craig ORCID: https://orcid.org/0000-0003-0348-6547, Meek, Keith ORCID: https://orcid.org/0000-0002-9948-7538 and Romano, Vito 2026. Polarimetric interferometry-derived isogyre parameters correlate with keratoconus severity: a retrospective observational study. Scientific Reports 10.1038/s41598-026-65845-2

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Abstract

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.

Item Type:	Article
Date Type:	Published Online
Status:	In Press
Schools:	Schools > Optometry and Vision Sciences
Publisher:	Nature Research
ISSN:	2045-2322
Date of First Compliant Deposit:	19 August 2026
Date of Acceptance:	4 August 2026
Last Modified:	19 Aug 2026 10:30
URI:	https://orca.cardiff.ac.uk/id/eprint/189082

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