ABCD progression display for keratoconus progression: a sensitivity-specificity study

Asaf Achiron*, Roy Yavnieli, Alon Tiosano, Uri Elbaz, Yoav Nahum, Eitan Livny, Irit Bahar

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review


Objective: To evaluate the sensitivity and specificity of the ABCD progression display for keratoconus progression. Methods: Data was collected from patients that underwent at least two Pentacam assessments 6 months apart. Sensitivity and specificity were calculated for the ABCD progression display. Progression was defined by criterion 1: change in two ABCD parameters above 80% confidence interval (CI) or criterion 2: change in one ABCD parameter above 95%CI. Receiver operating characteristic analysis compared the area under the curve (AUC) of all ABCD parameter combinations. Results: Thirty eyes were evaluated over a median time of 10.3 months. Progression by criterion 1 resulted in a sensitivity of 61.9% and specificity of 88.9%. Progression by criterion 2 resulted in higher sensitivity (80.9%) and specificity (100%). Pairwise comparisons of the ROC curves show that the AUC achieved by criterion 2 was significantly higher than criterion 1 (0.905 vs. 0.754, p = 0.0332). Evaluation of all ABCD combinations with a significant change of 80% or 95% CI did not show superiority over criterion 1 or 2 regarding progression detection. The D parameter had a very low AUC (0.5–0.556). Conclusions: The ABCD progression display can assess keratoconus progression with high sensitivity and specificity, thus assisting the patients’ decision-making process. The D parameter did not contribute to the sensitivity or specificity of this classification.

Original languageEnglish
Pages (from-to)1566-1570
Number of pages5
Issue number8
StatePublished - Jun 2023


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