&lt;p&gt;Corneal Imaging and Densitometry Measurements in Juvenile and Adult Keratoconus Patients to Evaluate Disease Progression and Treatment Effects After Corneal Cross-Linking&lt;/p&gt;

Alzahrani, Khaled; mofty, hanan; Lin, Emily Yc; Carley, Fiona; Brahma, Arun; Morley, Debbie; Biswas, Susmito; Hillarby, M. C.

doi:10.2147/opto.s226000

Cited by 7 publications

(4 citation statements)

References 31 publications

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“…In the current study, the mean values of corneal densitometry were peaked at the end of 3 months postoperatively with significant differences among the three groups. This is in agreement with a previously reported study by Alzahrani et al 16 …”

Section: Discussionsupporting

confidence: 94%

Corneal Haze and Densitometry in Keratoconus after Collagen Cross-Linking by Three Different Protocols

Badawi

2021

Journal of Current Ophthalmology

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Purpose: To evaluate postoperative corneal haze and corneal densitometry following three different corneal cross-linking (CXL) protocols; standard, accelerated, and trans-epithelial (TE). Methods: The study recruited 104 eyes (53 patients) with progressive keratoconus divided into three groups: Group I were subjected to standard CXL, Group II to TE-CXL, and Group III to accelerated CXL (A-CXL) (10 mW/cm 2 for 9 min). Subjective and objective corneal haze measures were evaluated before and 3, 6, and 12 months post-CXL using slit-lamp biomicroscopy and Pentacam Sheimpflug camera. Results: There was a significant difference in corneal densitometry between the three groups at 3 and 6 months post-CXL ( P < 0.0001). By the 12 th month, a significant statistical difference was observed only in zones (0–2 mm) and (2–6 mm) in both the anterior and the central layers. In Group I, the densitometry value of the preoperative anterior stromal layer (anterior 120 μm) was 19.42 ± 1.81. Then, it peaked at 23.12 ± 1.21 at 3 months ( P < 0.0001), reached 19.82 ± 1.19 at 6 months ( P = 0.007), and decreased to 19.33 ± 3.23 ( P > 0.05) at 12 months. In Group II, the preoperative densitometry value of the anterior layer was 19.41 ± 1.21, peaked at 19.72 ± 1.12 at 3 months ( P = 0.02), reached 19.04 ± 1.18 at 6 months ( P = 0.052), and increased to 19.13 ± 1.37 at 12 months ( P = 0.84). In Group III, the preoperative densitometry value of the anterior stromal layer was 19.53 ± 2.23. Then, it peaked at 24.80 ± 1.08 at 3 months ( P < 0.0001), decreased to 21.75 ± 1.11 at 6 months ( P < 0.0001), and reached 19.77 ± 2.26 at 12 months ( P = 0.047). There was no significant correlation between the visual acuity changes and the total corneal densitometry. Conclusion: The TE-CXL group showed a better and earlier recovery from the haze, while the A-CXL group showed a delay in recovering and persistent increased corneal densitometry, mainly in the anterior 120 μ.

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Section: Discussionsupporting

confidence: 94%

Corneal Haze and Densitometry in Keratoconus after Collagen Cross-Linking by Three Different Protocols

Badawi

2021

Journal of Current Ophthalmology

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“…Studies examining corneal densitometry changes after CXL in keratoconus differ in involved patients’ ages: some of these reports strictly contain adults over 18 years [ 12 , 15 , 36 , 37 ], whereas some of them involved patients under 18 years as well [ 11 , 13 , 38 ], although the presented tendencies in densitometry changes are similar. A recent study showed that in juvenile keratoconus patients significantly higher postoperative haziness can be observed after CXL compared to adults [ 39 ]. Our results showed that the postoperative densitometry changes after CXL depend rather on the keratoconus severity, than on the patients’ age, which is in consistent with the available literature [ 12 , 15 , 16 , 35 ].…”

Section: Discussionmentioning

confidence: 99%

Factors influencing haze formation and corneal flattening, and the impact of haze on visual acuity after conventional collagen cross-linking: a 12-month retrospective study

et al. 2021

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Background Our aim was to determine associations of pachymetry, keratometry, and their changes with haze formation and corneal flattening after collagen cross-linking, and to analyse the relationship between postoperative haze and visual outcome. Methods Retrospective analysis was performed on 47 eyes of 47 patients with keratoconus using the Pentacam HR Scheimpflug camera before and 1, 3, 6 and 12 months after cross-linking. Corneal backscattered light values in grey scale unit were recorded in the anterior, center and posterior corneal layers and in four concentric rings. Surface area- and thickness-corrected grey scale unit values were assessed with an additional calculation. Friedman test with post hoc Wilcoxon signed-rank test was used to analyse changes in visual acuity, pachymetry, keratometry and densitometry. Spearman’s rank correlation test was used to detect correlations of haze formation and corneal flattening with pachymetry, keratometry and their postoperative change. Generalized estimating equations analysis was used to investigate the influence of densitometry values on postoperative visual acuity after controlling for the effect of preoperative keratometry. Results One year after treatment, significant flattening was observed in maximum and mean keratometry readings (p < 0.001). Significantly increased densitometry values were observed in three central rings compared to baseline (post hoc p < 0.0125). According to receiver operating characteristic curve, densitometry value of the anterior layer of 0–2 mm ring was the most characteristic parameter of densitometry changes after cross-linking (area under the curve = 0.936). Changes in haze significantly correlated with preoperative maximum keratometry (R = 0.303, p = 0.038) and with the changes in maximum keratometry (R = -0.412, p = 0.004). Changes in maximum keratometry correlated with preoperative maximum keratometry (R = -0.302, p = 0.038). Postoperative haze had a significant impact on uncorrected and best corrected distance visual acuity (β coefficient = 0.006, p = 0.041 and β coefficient = 0.003, p = 0.039, respectively). Conclusions Our findings indicate that in more advanced keratoconus more significant corneal flattening effect parallel with haze formation can be observed after cross-linking. Despite significant reduction of keratometry, postoperative corneal haze may limit final visual acuity.

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“…21 The diagnosis of confirmed keratoconus and keratoconus suspects was made by two cornea specialists, ensuring accurate and reliable results. [21][22][23]…”

Section: Data Collectionmentioning

confidence: 99%

Prevalence of Keratoconus among Young Adults in Oman: A Cross-sectional Study Using Retinoscopy and Corneal Tomography

Al Saidi,

Almahroqi,

Bandara

et al. 2024

International Journal of Keratoconus and Ectatic Corneal Diseases

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Objective: This cross-sectional study aimed to determine the prevalence of keratoconus (KC) among young individuals in the Omani population, covering the entire country. Additionally, the severity of keratoconus was investigated after detection of the disease. Materials and methods: A total of 2750 participants were included in the study. The screening was conducted using retinoscopy (Phase 1) by well-trained optometrists, and those with a positive scissoring reflex underwent further assessment with corneal tomography to confirm the presence of keratoconus and assess its severity (Phase 2). Visual acuity and demographic data, such as age, sex, governorate, and village of residence, were collected during Phase 1, while corneal curvature parameters (K-Max, K-Mean, corneal thickness, back elevation) and keratoconus staging data were collected during Phase 2. Results: Out of the 2750 participants screened, 184 individuals between the ages of 20 and 34 were found to have a positive scissoring reflex. Among them, 96 cases were confirmed to have keratoconus in one or both eyes through corneal tomography, regardless of the severity stage. This yielded a prevalence rate of 3.49% among the study population. Among the positive keratoconus cases, 38 were males and 58 were females, with only 15 individuals aware of their keratoconus condition. Analysis of positive cases revealed the highest prevalence in the Al Batinah North governorate. Severity analysis based on topographic keratoconus classification displayed five eyes in stage 3-4, indicating advanced disease. Additionally, 75 cases had corneal parameters suspected of keratoconus on corneal tomography but did not meet the diagnostic criteria (based on the KSS score, This system grades the severity of keratoconus from 0 (suspect) to 5 (severe) based on two corneal topographic indices (i.e., anterior corneal higher order aberration RMS error and mean central keratometry), and 13 cases were confirmed as false-positive scissoring reflex. Conclusion:This study revealed a significant prevalence of keratoconus among young individuals in the Omani population. Compared with similar studies conducted in other parts of the world and neighboring countries, Oman appears to have a higher prevalence. Notably, a significant proportion of cases were already in advanced stages upon detection. Certain regions in Oman showed a higher prevalence, suggesting a potential relationship with geographic location and environmental factors. These findings warrant further investigation into the causative factors of keratoconus among the Omani population in the planned Phase 3 of the study. Close follow-up is recommended for cases suspected of having keratoconus but not meeting diagnostic criteria. Additionally, the lack of awareness among individuals with keratoconus, even in advanced stages, highlights the importance of population-based educational programs to promote early detection and intervention, ultimately preventing permanent visual disability.

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<p>Corneal Imaging and Densitometry Measurements in Juvenile and Adult Keratoconus Patients to Evaluate Disease Progression and Treatment Effects After Corneal Cross-Linking</p>

Cited by 7 publications

References 31 publications

Corneal Haze and Densitometry in Keratoconus after Collagen Cross-Linking by Three Different Protocols

Corneal Haze and Densitometry in Keratoconus after Collagen Cross-Linking by Three Different Protocols

Factors influencing haze formation and corneal flattening, and the impact of haze on visual acuity after conventional collagen cross-linking: a 12-month retrospective study

Prevalence of Keratoconus among Young Adults in Oman: A Cross-sectional Study Using Retinoscopy and Corneal Tomography

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