1. Rio de Janeiro Corneal Tomography and Biomechanics Study Group Dr. Ambrósio is consultant for Oculus Optikgeräte GmbH (Wetzlar, Germany) Agreement of Artificial Intelligence Topographic Diagnosis From Placido and Scheimpflug Systems Leonardo N. Pimentel, MD 1,2 ; Isaac Ramos, MD 1,2 ; Bruno Valbon, MD 1,2 Ana Laura C. Canedo, MD 1,2 Renato Ambrósio Jr., MD, PhD 1,2 1 – Instituto de Olhos Renato Ambrósio (Brazil) 2 – Rio de Janeiro Corneal Tomography and Biomechanics Study Group (Brazil)

2. Rio de Janeiro Corneal Tomography and Biomechanics Study Group Purpose To compare artificial intelligence in the axial curvature maps (sagittal), obtained by the topographic survey of Placido reflection system and those obtained using the rotating Scheimpflug system.

3. Rio de Janeiro Corneal Tomography and Biomechanics Study Group Methods Retrospective study. 449 patients (898 eyes) with axial topography by the Nidek Corneal Navigator System using the Magellan Placido’s Corneal Topographer and axial topography by the Pentacam using the Scheimpflug system.

4. Rio de Janeiro Corneal Tomography and Biomechanics Study Group Placido’s Corneal Topographer The corneal topography based on the Placido disk technology is a method that analyzes the anterior curvature assisted by a computer through the recording, capture and processing of the reflected rings that are illuminated and projected onto the cornea. Analysis of geometric shape of the reflected rings provides twenty two thousands measuring points that allow the construction of a topographic map.

5. Rio de Janeiro Corneal Tomography and Biomechanics Study Group Scheimpflug Corneal Topographer The Scheimpflug scanning provides considerably larger area measurement of the cornea compared with Placido’s topography systems. It is also not sensitive from irregularities on the corneal reflex and interference from the tear film. The exam generates curvature maps from the front and back corneal.

6. Rio de Janeiro Corneal Tomography and Biomechanics Study Group Methods Artific ial Intelli gence N ou AST KCSKC ou PMD PKP, MRS ou HRS OTH Numb er corres pondi ng 00,5132 To compare the artificial diagnoses, the corresponding numbers were used, then the percentage of agreement was observed. Was used Artificial intelligence by Nidek Corneal Navigator.

7. Rio de Janeiro Corneal Tomography and Biomechanics Study Group Methods 0 Negative O.5 Possible 1 Positive 2 Abnormal 3 Post- surgery Was used TKC system by Pentacam (Oculus). The pacients that made hypermetropic Lasik were excluded from the Study, because TKC system didn`t have program for this cases.

8. Rio de Janeiro Corneal Tomography and Biomechanics Study Group Results Observed agreement between diagnoses Artificial by Maguellan (Nidek Cornea Navigator) and TKC from Pentacam (Oculus) in 525 eyes (58%) and disagreement in 373 eyes (48%). The agreement between diagnoses Artificial by maguellan and TKC system by Pentacam was better in normal and keratoconus cases, while was worse in suspect cases. 525 Eyes

9. Rio de Janeiro Corneal Tomography and Biomechanics Study Group Conclusions The axial topography by the Pentacam using Scheimpflug system is not sensitive from irregularities on the corneal reflex and interference from the tear film. Especially in suspicious cases, is necessary additional data from tomography or biomechanics study to enhance the sensitivity and specificity to detect ectasia.