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

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

doi:10.1038/s41433-022-02183-3

Cited by 4 publications

(2 citation statements)

References 30 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Despite the time that has passed since the study period, Scheimpflug imaging remains the most commonly utilised diagnostic tool [ 31 – 33 ]. Guidelines for CXL have also not changed significantly since the study period, with consensus for keratoconus progression still largely utilising the ABCD progression and the criteria of 1–1.5D increase in Kmax over one year [ 9 , 24 ]. Although more optometrists are purchasing corneal topographers primarily for the fitting of complex contact lens designs and especially for orthokeratology contact lens fittings, this instrumentation is not widely available in optometric practice.…”

Section: Discussionmentioning

confidence: 99%

“…Refraction and visual acuity are important yet often undervalued tools in the work-up and monitoring of keratoconus progression. Of note, the Pentacam’s ABCD progression display utilises distance visual acuity as one of the indices to document keratoconus progression, however, most studies focus on the role of the former 3 ABC parameters in detecting disease progression with less emphasis on the role of visual acuity in the literature [ 7 , 23 , 24 ]. To date, no study has specifically investigated rates of progression in best spectacle-corrected visual acuity (BSCVA) or refractive error in keratoconic patients prior to diagnosis, nor compared these parameters between keratoconic and non-keratoconic subjects.…”

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

Patterns in refractive error and treatment delay in keratoconus–An Australian study

Bobba,

Wood,

Males

et al. 2024

PLoS ONE

View full text Add to dashboard Cite

Keratoconus is the most common primary corneal ectasia and is associated with significant morbidity. In its early stages, keratoconus is often asymptomatic, making the identification of subclinical disease challenging. Refractive error is a parameter that is documented at most routine optometry visits, yet interestingly, changes in refraction of keratoconic patients over time have not yet been studied and compared with the general population. Early diagnosis of keratoconus facilitates timely referral for treatments such as corneal collagen cross-linking, which has been shown to slow disease progression. In this context, documenting delays between initial presentation to the optometrist and referral for collagen-cross-linking as well as comparing the trends in visual acuity and refractive error between keratoconic and non-keratoconic patients over time are particularly relevant.

show abstract

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Patterns in refractive error and treatment delay in keratoconus–An Australian study

Bobba,

Wood,

Males

et al. 2024

PLoS ONE

View full text Add to dashboard Cite

show abstract

Dynamics of Corneal Swelling With Hypoosmolar Riboflavin After Induction During Corneal Collagen Crosslinking in Patients With Progressive Keratoconus

Syed,

Yu,

Crespo

et al. 2024

Cornea

View full text Add to dashboard Cite

Purpose: To evaluate the rate of corneal swelling induced by hypoosmolar riboflavin in patients with progressive keratoconus (KCN) with corneal thickness <400 µm after the induction phase using riboflavin with 20% dextran during epithelium-off corneal crosslinking (CXL). Methods: Prospective, nonrandomized, single-center consecutive case series. Preoperative assessments included tomography, specular microscopy, and hysteresis. After epithelial debridement, riboflavin with 20% dextran (Photrexa Viscous; Glaukos, Burlington, MA) was applied at 2-min intervals during a 30-min induction phase. Eyes that dehydrated to a minimum corneal thickness (MCT) of <400 µm after induction (postinduction pachymetry) were recruited. Hypoosmolar riboflavin 0.146% (Photrexa; Glaukos) was used every 10 s to induce stromal swelling, with pachymetry performed every 30 s until the MCT was ≥400 µm (postswelling pachymetry). Corneal swelling rate was compared with variables using regression analysis. Results: In 31 eyes of 31 patients, mean postinduction pachymetry was 338.4 ± 28.7 μm. Hypoosmolar riboflavin induced a postswelling pachymetry of 413.4 ± 15.0 μm over a mean of 5.2 ± 3.2 min, and the average stromal swelling rate was 10.3 ± 8.7 μm/30 s. All eyes reached a postswelling pachymetry MCT ≥400 µm and no cases were aborted. Eyes with highly severe KCN (Kmax >70 and Belin/Ambrosio enhanced ectasia display final D score >17) experienced quicker swelling (14.4 ± 12.8 μm/30 s and 14.9 ± 12.4 μm/30 s, respectively; P < 0.05 for both). A thicker postinduction pachymetry was moderately associated with a faster rate of swelling (rs = 0.389; P = 0.030). Conclusions: Hypoosmolar riboflavin 0.146% can be safely employed in thinner corneas, allowing for swelling to ≥400 µm for epithelium-off CXL. Associations between swelling rate, KCN severity, and postinduction pachymetry were determined, allowing for a more accurate prediction of procedure time during CXL.

show abstract

Definition of Progressive Keratoconus: A Systematic Review

Henriquez,

Larco,

Izquierdo

2024

Cornea

View full text Add to dashboard Cite

Purpose: To identify the definitions used for progressive keratoconus in the literature. Methods: A systematic literature review aimed to identify the definitions used for “progressive keratoconus” in the published articles. A comprehensive search from January 2018 to May 2023 was conducted across Cochrane Library, PubMed, Taylor & Francis, Web of Science, and other bibliographic databases at Oftalmosalud, Lima, Peru. The inclusion criteria were articles including patients with keratoconus without any previous surgical procedure and containing the definition of “progressive keratoconus” or “keratoconus progression” and a sample size greater than 10 eyes. Results: A total of 221 articles were included for analysis. The 3 most frequent parameters to define progression included data from anterior curvature, pachymetry, and refraction used in 97.8% (216/221), 37.6% (83/221), and 32.1% (71/221) of the articles, respectively. Specifically, the most frequent criterion used was maximum keratometry (Kmax), used in 85.5% (189/221) of the articles. Progression was assessed between 6- and 12-month follow-up in 64.7% (143/221) of the articles. Data from posterior cornea were used in only 8.1% (18/221) of the studies. None of the studies included data from the corneal epithelium. Conclusions: The present study demonstrates the lack of unified criteria to define progression of keratoconus and an underutilization of the technology described. It also shows that the single point Kmax measurement is the most commonly used criterion, followed by a change in refractive astigmatism and thinning at the thinnest pachymetric point.

show abstract

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

Cited by 4 publications

References 30 publications

Patterns in refractive error and treatment delay in keratoconus–An Australian study

Patterns in refractive error and treatment delay in keratoconus–An Australian study

Dynamics of Corneal Swelling With Hypoosmolar Riboflavin After Induction During Corneal Collagen Crosslinking in Patients With Progressive Keratoconus

Definition of Progressive Keratoconus: A Systematic Review

Contact Info

Product

Resources

About