Pediatric Corneal Epithelial Thickness Profiles by Anterior Segment Optical Coherence Tomography: Normative Data and Clinical Implications.

Purpose: To determine normative corneal epithelial thickness (CET) profiles in healthy Turkish children using anterior segment optical coherence tomography (AS-OCT), and to explore regional variations and associations with demographic and refractive parameters.

Methods: This cross-sectional observational study was conducted at a tertiary eye hospital and included 86 healthy children aged 7 to 18 years. One eye per participant was randomly selected. All participants underwent complete ophthalmic examination, cycloplegic autore-fraction, and AS-OCT imaging. CET measurements were obtained from central (2-mm), paracentral (5-mm), and midperipheral (6-mm) zones across eight radial sectors. Statistical analyses included sex-based comparisons, quadrant-based thickness differences, and correlation analyses with age and refractive parameters.

Results: Mean central CET was 53.7 ± 4.6 µm. Epithelial thickness (ET) decreased toward the periphery, with inferior and inferonasal sectors being thickest and superior sectors thinnest. Males exhibited significantly greater CET in several paracentral and midperipheral sectors (P < .05). Quadrant-based comparisons revealed consistent asymmetry: ET was greater in inferior and nasal sectors compared to superior and temporal regions, whereas corneal thickness was lower in the inferior and temporal quadrants relative to superior and nasal counterparts (P < .001). Central CET showed no correlation with age or refractive error, whereas paracentral nasal and temporal sectors exhibited weak age-related thinning (P < .05).

Conclusions: This study provides normative pediatric CET data, highlighting characteristic spatial variations and subtle sex-based differences. These findings support the clinical utility of epithelial mapping in early keratoconus detection and its integration into artificial intelligence-based diagnostic systems.