Background:The image optical quality is affected by changes in corneal shape of patients with keratoconus.The goal of this study was to explore which corneal parameters determine the visual quality in keratoconus subjects, which corneal slope parameter has the strongest correlation with visual quality and contrast sensitivity. Methods:The study covered eyes of 77 subjects, graded from the first to third keratoconus stages. To characterize the shape of cornea, we obtained measurements in two ways: (a) projected two perpendicular axes onto a corneathe main axis passed through the central point of the cornea (visual axis projection) and keratoconus apex, while the second axis was perpendicular to the main axisand read elevation values at points on theses axis; (b) projected circles with different diameters around the central part of the cornea (1, 2 and 3 mm) and read elevation values at points equally displaced on these circles. The measurements were used to calculate various elevation change (slope) parameters.Results: According to the acquired data, the visual acuity of a corrected eye does not have a strong correlation with the measured keratoconus apex slope. Contrast sensitivity displayed a strong correlation with keratoconus slope in the central part of the cornea (with a radius of 1 mm). Correlations in different spatial frequencies ranging from 0.47 to 0.6. Conclusion:Contrast sensitivity is more important parameter which describes the visual quality of keratoconus subjects than visual acuity. The most important region which determines the visual quality in keratoconus subjects is the region with a 1 mm radius of the corneal centre in the opposite direction of keratoconus apex.

Background: To understand which irregular corneal parameters determine the visual quality in keratoconus subjects. Methods: The cross-sectional study examined the eyes of 44 subjects, graded from the first to third keratoconus stages by Amsler-Krumeich classification. We obtained measurements in two ways: (a) by projecting two perpendicular axes onto a cornea (first, through the central point of the cornea and keratoconus apex; second, as the perpendicular axis) to read the elevation values at points on these axes as parameters characterising the corneal surface; (b) by projecting circles with different diameters around the central part of the cornea (1, 2, and 3 mm) and reading elevation values at points equally displaced on these circles as parameters characterising an anterior surface slope. Irregular corneal shape parameters’ correlations with visual acuity and contrast sensitivity were determined in order to understand which corneal slope parameter has the strongest correlation with visual acuity and contrast sensitivity.Results: .Parameters characterising the corneal surface’s correlations with contrast sensitivity were from r=0.25 (p=0.03) at 3 cpd to r=0.47 (p<0.01) at 9 cpd for the highest elevation and from r=0.33 (p=0.09) at 5 cpd to r=0.40 (p<0.01) at 11 cpd for the lowest elevation in all subjects together, while for visual acuity the parameters were r=0.30 (p<0.01) for the highest elevation and r=0.21 (p=0.06) for the lowest elevation in all subjects together. The correlation between contrast sensitivity and the highest and lowest corneal point in all measured cornea was stronger for subjects with a peripheral corneal apex than for those with a central apex. In keratoconus subjects, contrast sensitivity displayed a strong correlation with slope in the central part of the cornea (with a radius of 1 mm) ranging from 0.48 (p<0.01) at 3 cpd to 0.61 (p<0.01) at 9 cpd.Conclusion: Contrast sensitivity has a higher correlation with corneal shape parameters than with visual acuity. Subjects with a peripheral corneal apex had stronger correlations with visual acuity and contrast sensitivity than did subjects with a central apex. In keratoconus subjects, the strongest correlation was for contrast sensitivity and elevation (slope) in the region within a 1 mm radius of the corneal centre in the opposite direction of the keratoconus apex (direction (ax) CB).

Background To understand which irregular corneal parameters determine the visual quality in keratoconus subjects. Methods The cross-sectional study examined the eyes of 44 subjects, graded from the first to third keratoconus stages by Amsler-Krumeich classification. We obtained measurements in two ways: (a) by projecting two perpendicular axes onto a cornea (first, through the central point of the cornea and keratoconus apex; second, as the perpendicular axis) to read the elevation values at points on these axes as parameters characterising the corneal surface; (b) by projecting circles with different diameters around the central part of the cornea (1, 2, and 3 mm) and reading elevation values at points equally displaced on these circles as parameters characterising an anterior surface slope. Irregular corneal shape parameters’ correlations with visual acuity and contrast sensitivity were determined in order to understand which corneal slope parameter has the strongest correlation with visual acuity and contrast sensitivity. Results Parameters characterising the corneal surface’s correlations with contrast sensitivity were from r = 0.25 (p = 0.03) at 3 cpd to r = 0.47 (p < 0.01) at 9 cpd for the highest elevation and from r = 0.33 (p = 0.09) at 5 cpd to r = 0.40 (p < 0.01) at 11 cpd for the lowest elevation in all subjects together, while for visual acuity the parameters were r = 0.30 (p < 0.01) for the highest elevation and r = 0.21 (p = 0.06) for the lowest elevation in all subjects together. The correlation between contrast sensitivity and the highest and lowest corneal point in all measured cornea was stronger for subjects with a peripheral corneal apex than for those with a central apex. In keratoconus subjects, contrast sensitivity displayed a strong correlation with slope in the central part of the cornea (with a radius of 1 mm) ranging from 0.48 (p < 0.01) at 3 cpd to 0.61 (p < 0.01) at 9 cpd. Conclusion Contrast sensitivity has a higher correlation with corneal shape parameters than with visual acuity. Subjects with a peripheral corneal apex had stronger correlations with visual acuity and contrast sensitivity than did subjects with a central apex. In keratoconus subjects, the strongest correlation was for contrast sensitivity and elevation (slope) in the region within a 1 mm radius of the corneal centre in the opposite direction of the keratoconus apex (direction (ax) CB).

Various studies have demonstrated that patients with keratoconus have significant loss of contrast sensitivity while its value varies in different studies. None of these studies has analysed reduced contrast sensitivity depending on the position of apex of corneal conus. Visual acuity and contrast sensitivity were evaluated for patients with keratoconus using the FrACT software. Contrast sensitivity was assessed at the following frequencies: 1, 3, 5, 7, 9, 11, 13, and 15

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