Screening for Subclinical Keratoconus and Prevention of Corneal Ectasia with SCORE Analyzer Software

  • Damien GatinelEmail author


SCORE software is an artificial intelligence computer programme designed to provide an aid to clinical decision-making in refractive surgery for the early detection and follow-up of keratoconus. It was designed by Dr. Damien Gatinel and Alain Saad between 2009 and 2011 and obtained the CE mark in December 2013. It is based on the results of a clinical research study using Orbscan topography data (Bausch & Lomb, Technolas PV, Germany).


Forme fruste keratoconus Keratoconus Orbscan SCORE Screening Discriminant Analysis 


  1. 1.
    Saad A, Gatinel D. Topographic and tomographic properties of forme fruste keratoconus corneas. Invest Ophthalmol Vis Sci. 2010;51(11):5546–55.CrossRefPubMedGoogle Scholar
  2. 2.
    Wei RH, Zhao SZ, Lim L, Tan DT. Incidence and characteristics of unilateral keratoconus classified on corneal topography. J Refract Surg. 2011;27(10):745–51.CrossRefPubMedGoogle Scholar
  3. 3.
    Rabinowitz YS, Nesburn AB, McDonnell PJ. Videokeratography of the fellow eye in unilateral keratoconus. Ophthalmology. 1993;100(2):181–6.CrossRefPubMedGoogle Scholar
  4. 4.
    Gatinel D, Saad A. The challenges of the detection of subclinical keratoconus at its earliest stage. Int J Keratoco Ectatic Corneal Dis. 2012;1(1):36–43.CrossRefGoogle Scholar
  5. 5.
    Muftuoglu O, Ayar O, Ozulken K, Ozyol E, Akıncı A. Posterior corneal elevation and back difference corneal elevation in diagnosing forme fruste keratoconus in the fellow eyes of unilateral keratoconus patients. J Cataract Refract Surg. 2013;39(9):1348–57.CrossRefPubMedGoogle Scholar
  6. 6.
    Smadja D, Touboul D, Cohen A, Doveh E, Santhiago MR, Mello GR, Krueger RR, Colin J. Detection of subclinical keratoconus using an automated decision tree classification. Am J Ophthalmol. 2013;156(2):237–46.CrossRefPubMedGoogle Scholar
  7. 7.
    Bühren J, Kook D, Yoon G, Kohnen T. Detection of subclinical keratoconus by using corneal anterior and posterior surface aberrations and thickness spatial profiles. Invest Ophthalmol Vis Sci. 2010;51(7):3424–32.CrossRefPubMedGoogle Scholar
  8. 8.
    Fontes BM, Ambrósio R Jr, Salomão M, Velarde GC, Nosé W. Biomechanical and tomographic analysis of unilateral keratoconus. J Refract Surg 2010;26(9):677–681.Google Scholar
  9. 9.
    Saad A, Gatinel D. Validation of a new scoring system for the detection of early forme of keratoconus. Int J Keratoco Ectatic Corneal Dis. 2012;1(2):100–8.CrossRefGoogle Scholar
  10. 10.
    Saad A, Gatinel D. Association of corneal indices for the detection of ectasia-susceptible corneas. J Refract Surg. 2012;28(3):166. author reply 166-7PubMedGoogle Scholar
  11. 11.
    Saad A, Hodge C, Lawless M, Gatinel D. Retrospective testing of a new method for detecting ectasia-susceptible corneas. J Cataract Refract Surg. 2011;37(10):1907–8.CrossRefPubMedGoogle Scholar
  12. 12.
    Ambrósio R Jr, Alonso RS, Luz A, Coca Velarde LG. Corneal-thickness spatial profile and corneal-volume distribution: tomographic indices to detect keratoconus. J Cataract Refract Surg 2006;32(11):1851–1859.Google Scholar
  13. 13.
    Ambrósio R Jr, Klyce SD, Wilson SE. Corneal topographic and pachymetric screening of keratorefractive patients. J Refract Surg 2003;19(1):24–29.Google Scholar
  14. 14.
    Gatinel D, Malet J, Azar ST. Corneal elevation topography: best fit sphere, elevation distance, asphericity, toricity and clinical implications. Cornea. 2011;30(5):508–15.CrossRefPubMedPubMedCentralGoogle Scholar
  15. 15.
    Gatinel D, Racine L, Hoang-Xuan T. Contribution of the corneal epithelium to anterior corneal topography in patients having myopic photorefractive keratectomy. J Cataract Refract Surg. 2007;33(11):1860–5.CrossRefPubMedGoogle Scholar
  16. 16.
    Chan C, Ang M, Saad A, et al. Validation of an objective scoring system for forme fruste keratoconus detection and post-LASIK ectasia risk assessment in Asian eyes. Cornea. 2015;34(9):996–1004.CrossRefPubMedGoogle Scholar
  17. 17.
    Reinstein DZ, Archer TJ, Urs R, et al. Detection of keratoconus in clinically and algorithmically topographically normal fellow eyes using epithelial thickness analysis. J Refract Surg. 2015;31(11):736–44.CrossRefPubMedPubMedCentralGoogle Scholar

Copyright information

© Springer International Publishing AG 2018

Authors and Affiliations

  1. 1.Rothschild FoundationParisFrance

Personalised recommendations