Pentacam top indices for diagnosing subclinical and definite keratoconus

Hashemi, Hassan; Beiranvand, Asghar; Yekta, Abbasali; Maleki, Azam; Yazdani, Negareh; Khabazkhoob, Mehdi

doi:10.1016/j.joco.2016.01.009

Cited by 145 publications

(139 citation statements)

References 20 publications

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“…This is an advantage when interpreting results that aren´t biased by age and sex. As reported by Koçamis et al [25], there are significant differences for age between keratoconus (26.19 ± 7.90) and healthy (30.88 ± 7.57) Pupillary dilatation is another parameter that can modify the aberrometry results [30]. In this study, it was prefixed in 6 mm.…”

Section: Discussionmentioning

confidence: 66%

“…In this study, it was prefixed in 6 mm. In previous studies [8, 12-14, 20-23, 29] like Hondur et al [30] established it in 5 mm.…”

Section: Discussionmentioning

confidence: 86%

“…The purpose in most of them was to analyze the topographic parameters to find differences between a healthy patient and an incipient corneal ectasia without symptoms. However in all of them, many different classification methods have been used: Amsler-Krumeich [27,[30][31], Alió and Shabayek [15,23], KISA % index [24] or KSS [32]. All this methodological variability leads to an outstanding selection and classification bias when making comparisons between studies.…”

Section: Discussionmentioning

confidence: 99%

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A predictive model for early diagnosis of keratoconus

Castro-Luna

Pérez-Rueda

2020

Preprint

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Abstract Background: The diagnosis of keratoconus in the early stages of the disease is necessary to initiate an early treatment of keratoconus. Furthermore, to avoid possible refractive surgery that could produce ectasias. This study aims to describe the topographic, pachymetric and aberrometry characteristics in patients with keratoconus, subclinical keratoconus and normal corneas. Additionally to propose a diagnostic model of subclinical keratoconus based in binary logistic regression models Methods: The design was a cross-sectional study. It included 205 eyes from 205 patients distributed in 82 normal corneas, 40 early-stage keratoconus and 83 established keratoconus. The rotary Scheimpflug camera (Pentacam® type) analyzed the topographic, pachymetric and aberrometry variables. It performed a descriptive and bivariate analysis of the recorded data. A diagnostic and predictive model of early-stage keratoconus was calculated with the statistically significant variables Results: Statistically significant differences were observed when comparing normal corneas with early-stage keratoconus/ in variables of the vertical asymmetry to 90º and the central corneal thickness. The binary logistic regression model included the minimal corneal thickness, the anterior coma to 90º and posterior coma to 90º. The model properly diagnosed 92% of cases with a sensitivity of 97.59%, specificity 98.78%, accuracy 98.18% and precision 98.78%Conclusions: The differential diagnosis between normal cases and subclinical keratoconus depends on the mínimum corneal thickness, the anterior coma to 90º and the posterior coma to 90º.

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Section: Discussionmentioning

confidence: 66%

“…In this study, it was prefixed in 6 mm. In previous studies [8, 12-14, 20-23, 29] like Hondur et al [30] established it in 5 mm.…”

Section: Discussionmentioning

confidence: 86%

Section: Discussionmentioning

confidence: 99%

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A predictive model for early diagnosis of keratoconus

Castro-Luna

Pérez-Rueda

2020

Preprint

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“…The Belin/Ambrósio enhanced ectasia display (BAD) takes into account the deviations from normal to distinct parameters so that the value zero represents the average of the normal population and the value one represents a standard deviation toward the value of the disease. 4 The "final D," currently in the third version, is calculated based on a regression analysis, in which values above 2.6 are presented in red and would be highly indicative of keratoconus. Table 1 summarizes the most relevant objective values.…”

Section: Discussionmentioning

confidence: 99%

“…Interestingly, mild, early or fruste keratoconus may be challenging to detect, requiring the conscious use of advanced corneal imaging. 3,4 We report the case who presented for second opinion due to severe symptoms related to quality of vision after toric multifocal IOL implantation in whom the diagnosis of mild ectatic disease was done, indicating IOL exchange.…”

Section: Introductionmentioning

confidence: 99%

Importance of Screening for Ectatic Corneal Disease Prior to Multifocal Intraocular Lens

Ambrósio¹,

Hallal²

2018

International Journal of Keratoconus and Ectatic Corneal Diseases

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Aim: This article reports the case of a patient with severe symptoms related to bad quality of vision after toric multifocal intraocular lens (IOL) that was diagnosed with mild keratoconus. Materials and methods:To present a case report and prospectively review of the literature, considering the relevance of screening ectaticconreal disease prior to refractive cataract (or lens) surgery. Results:The patient was dissatisfied, seeking a second opinion after the implantation of a toric multifocal IOL in the left eye. The IOL was properly centered and surgery had no complications. The preoperative refraction was −4.00 − 1.50 × 160, giving 20/40. Patient denied any history of keratoconus or transplant in his family. After cataract surgery, uncorrected distance vision acuity (UDVA) was 20/60, and J4 for near. Manifest refraction was + 2.00 − 0.50 × 130, giving 20/30. Corneal topography, tomography, and biomechanical assessments indicated the diagnosis of mild keratoconus. The patient was advised for IOL exchange, which was successfully done for a monofocal aspheric IOL. The patient was satisfied with the final result, presenting a final UDVA of 20/25, J3, and manifest refraction of +0.75 − 0.50 × 105, giving 20/20. Conclusion:Screening for corneal abnormalities including ectatic corneal disease is fundamental prior to the indication of a premium lens. Advanced corneal imaging plays a fundamental role to help select candidates for multifocal IOLs, as for individualized planning of refractive cataract surgery.

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Clinical Evaluation and Validation of the Dutch Crosslinking for Keratoconus Score

et al. 2019

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IMPORTANCE Defining keratoconus progression is fundamental in clinical decision making because crosslinking treatments are indicated when the disease is considered progressive. Currently, there is no consensus which parameters should be used to define progression. OBJECTIVE To assess and validate a novel clinical scoring system as an easy-to-use assessment tool for crosslinking treatment in patients with keratoconus. DESIGN, SETTING, AND PARTICIPANTSProspective cohort study at 2 academic treatment centers. Patients with keratoconus referred between January 1, 2012, and June 30, 2014, with 2-year follow-up were included. Analysis began March 2017. INTERVENTIONSThe Dutch Crosslinking for Keratoconus (DUCK) score is based on changes in 5 clinical parameters that are routinely assessed: age, visual acuity, refraction error, keratometry, and subjective patient experience. The DUCK score is derived by scoring 0 to 2 points per item, and cutoffs were determined by clinical experience. We compared the DUCK scores to the conventional 1.0-diopter increase in maximum keratometry criterion, within the last 12 months, in a longitudinal discovery and a validation cohort. Sensitivity analyses and intraitem correlations were performed. MAIN OUTCOMES AND MEASURESOverall treatment rate reduction and the duly withheld treatment rate.RESULTS A total of 504 eyes of 388 patients were available for analysis on disease progression in the course of 12 and 24 months. Baseline patient characteristics of the discovery cohort and the validation cohort were comparable in terms of age (mean [SD], 26.8 [8.3] years vs 26.3 [9.1]), sex (216 of 332 [65%] vs 123 of 172 [72%] men), and maximum keratometry (mean [SD], 53.5 [7.1] vs 52.7 [6.3]). Adhering to the DUCK score, rather than maximum keratometry, was associated with a reduction in overall treatment rate by 23% (95% CI, 18%-30%), without increasing the risk of disease progression (ie, the rate of progression for both groups was equal; ±0%). The DUCK score appears to better identify eyes that were duly withheld treatment by 35% (95% CI, 22%-49%).CONCLUSIONS AND RELEVANCE These results provide validation of the DUCK score as a tool to determine whether a crosslinking treatment might be warranted. Compared with the conventional maximum keratometry criterion of more than 1.0 diopter, the DUCK score may better select patients who might benefit from crosslinking treatment. Potentially, it may prevent unnecessary treatments, reduce exposure to treatment risks, and improve the cost effectiveness of crosslinking.

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Pentacam top indices for diagnosing subclinical and definite keratoconus

Cited by 145 publications

References 20 publications

A predictive model for early diagnosis of keratoconus

A predictive model for early diagnosis of keratoconus

Importance of Screening for Ectatic Corneal Disease Prior to Multifocal Intraocular Lens

Clinical Evaluation and Validation of the Dutch Crosslinking for Keratoconus Score

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