Evaluation, Variability Factors and Clinical Applications of Corneal Densitometry

Abstract

The cornea is a transparent, avascular tissue essential for visual acuity, providing two-thirds of the refractive power of the eye. Its transparency depends on the integrity of its biological components, which can be affected by various conditions. Traditionally, its evaluation is performed by slit lamp, a subjective method. Therefore, objective techniques such as corneal densitometry, which measures light backscattering and provides an accurate quantitative assessment using systems such as Pentacam, have been developed. This study reviews the literature on corneal densitometry, its methods of evaluation, factors influencing the results and its clinical application. Densitometry is higher in the anterior stratum of the cornea, due to the arrangement of keratocytes and collagen fibers. Factors such as age, sex, ethnicity, ocular and systemic diseases, corneal diameter and illumination affect the results. Research in different populations has established normative values, identifying variations according to region and individual characteristics. Densitometry is used for the follow-up of diseases such as keratoconus and Fuchs' dystrophy, as well as post-surgical evaluation of corneal photoablative refractive procedures and collagen crosslinking, which can alter long-term values. Although this technology has advanced, more research is needed to fully understand the impact of various variables on outcomes and their relationship to visual health.