Corneal Scarring in the Collaborative Longitudinal Evaluation of Keratoconus (CLEK) Study

Barr, Joseph T.; Schechtman, Kenneth B.; Fink, Barbara A.; Pierce, Gilbert E.; Pensyl, C. Denise; Zadnik, Karla; Gordon, Mae O.

doi:10.1097/00003226-199901000-00007

Cited by 76 publications

(40 citation statements)

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“…Exposed but undeveloped film was mailed to the CLEK Photography Reading Center (CPRC) for centralized development and grading by masked examiners. [5] One-hundred thirty-eight patients were randomly selected by the Coordinating Center for inclusion in the test-retest portion of the study, to assess the repeatability of standard test measures for patients with keratoconus, including visual acuity, refraction [6][7][8], and corneal curvature. [7,9] Distance visual acuity was measured with high-and low-contrast Bailey-Lovie charts [10] (School of Optometry, University of California, Berkeley, CA) utilizing the Early Treatment Diabetic Retinopathy Study protocol.…”

Section: Methodsmentioning

confidence: 99%

Collaborative Longitudinal Evaluation of Keratoconus (CLEK) Study: Methods and findings to date

Wagner

Barr

Zadnik

2007

Contact Lens and Anterior Eye

280

205

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Purpose-To describe baseline and longitudinal findings of the Collaborative Longitudinal Evaluation of Keratoconus (CLEK) Study.Methods-The CLEK Study is an eight-year, multi-center, natural history study of 1,209 patients with keratoconus who were examined annually for eight years. Its goals are to prospectively characterize changes in vision, corneal curvature, corneal status, and vision-specific quality of life.Results-CLEK Study subjects had a mean age at baseline of 39.3 +/− 10.9 years. At study entry, 65% of the patients wore rigid contact lenses, and 14% reported a family history of the disease. Subjects exhibited a seven-year decrease in high-(2.03 letters) and low-(4.06 letters) contrast, best-corrected visual acuity, with 19% demonstrating decreases of 10 or more letters in high-contrast, best-corrected acuity and 31% of subjects demonstrating decreases of 10 or more letters in low-contrast, best-corrected acuity in at least one eye. Subjects exhibited an average eight-year increase in corneal curvature of 1.60 D in the flat corneal meridian, with 24% demonstrating increases of 3.00 D or more. The eight-year incidence of corneal scarring was 20%, with younger age, corneal staining, steeper baseline corneal curvature, contact lens wear, and poorer low-contrast visual acuity predictive of corneal scarring. Data from the National Eye Institute Visual Function Questionnaire suggest that the effect of keratoconus on vision-specific quality of life is disproportionate to its low prevalence and clinical severity.Conclusion-Although we report measures of disease severity and visual function across the CLEK sample, clinicians can begin to envisage the course of keratoconus in individual patients by determining whether factors predictive of disease progression are present in those patients.

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Section: Methodsmentioning

confidence: 99%

Collaborative Longitudinal Evaluation of Keratoconus (CLEK) Study: Methods and findings to date

Wagner

Barr

Zadnik

2007

Contact Lens and Anterior Eye

280

205

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“…These breaks cause stromal edema, vision loss and associated pain. [10][11][12] However, the most sensitive method of detecting early KC is corneal topography. Typical patterns of irregular astigmatism are described by Rabinowitz.…”

Section: Diagnosis Of Keratoconusmentioning

confidence: 99%

The Epidemiology and Etiology of Keratoconus

Gordon‐Shaag¹,

Millodot²,

Shneor³

2012

International Journal of Keratoconus and Ectatic Corneal Diseases

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Keratoconus is a noninflammatory disorder characterized by ectasia of the central or inferior portion of the cornea. This review presents the scant epidemiological information known to date and the factors believed to cause the development of the disease. They are the genetic factors for which evidence come from family studies, twin studies and genetic loci. There appears to be multiple genes causing a keratoconus phenotype with variable penetration. However, the genetic predisposition might not be enough; environmental factors, such as eye rubbing, atopy and UV exposure, may have a role in generating the disease.

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“…Corneal staining was assessed after addition of sodium fluorescein (BioGlo ophthalmic strips; Hub Pharmaceuticals, Rancho Cucamoga, 38 Type, surface area, and density of corneal staining were recorded in each of five corneal zones according to modified versions of the IER staining criteria, as listed in Figure 1. Each image series was graded by two trained readers and adjudicated by a third reader.…”

Section: Collection and Classification Of Covariatesmentioning

confidence: 99%

Risk Factors for Corneal Infiltrative Events during Continuous Wear of Silicone Hydrogel Contact Lenses

Szczotka-Flynn

Lass

Sethi

et al. 2010

Invest. Ophthalmol. Vis. Sci.

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Corneal Scarring in the Collaborative Longitudinal Evaluation of Keratoconus (CLEK) Study

Abstract: The use of a vaccination with heat shock-inactivated herpes simplex virus 1 seems to be able to reduce the number and duration of relapses in herpes simplex virus 1-related keratitis/keratouveitis.

Cited by 76 publications

References 0 publications

Collaborative Longitudinal Evaluation of Keratoconus (CLEK) Study: Methods and findings to date

Collaborative Longitudinal Evaluation of Keratoconus (CLEK) Study: Methods and findings to date

The Epidemiology and Etiology of Keratoconus

Risk Factors for Corneal Infiltrative Events during Continuous Wear of Silicone Hydrogel Contact Lenses

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