The Correlation between Corneal Findings and Disease Severity in Keratoconus per Scheimpflug Corneal Tomography

Abstract

is properly cited.Purpose. is study aims to correlate the clinical signs of keratoconus (KC) which include superficial apical scarring, Fleischer rings, and Vogt striae with best spectacle-corrected visual acuity (BSCVA) and corneal tomography findings. Patients and methods. A retrospective observational study. 72 consecutive KC patients seen by the senior author over the course of one year were included in this case series. Eyes with pellucid marginal degeneration, postrefractive ectasia, history of a corneal graft, prior corneal collagen cross-linking, intracorneal ring segments or hydrops were excluded from analysis. Subsequently, the final analysis included only treatment-naïve KC eyes with varying degrees of disease severity. Results. BSCVA with manifest refraction was 0.5 logMAR higher in eyes with apical scarring (p < 0.001). Eyes with apical scarring had worse vision than eyes with Fleischer rings alone (0.43 logMAR higher in the former, p < 0.009). Eyes with apical scarring had higher keratometry readings (K2 = 64.56 ± 12.89 D versus 49.07 ± 6.61 D, p < 0.001); this was also true for eyes with Fleischer rings compared with ring-free eyes (K2 = 56.23 ± 11.52 D versus 48.91 ± 7.79 D, p < 0.001) and eyes with Vogt striae (K2 = 56.19 ± 10.27 D versus 50.68 ± 9.21 D, p � 0.01). Atopic disease was a risk factor for scarring: odds ratio (OR) = 2.87 (p � 0.03). e OR of observing Fleischer rings in KC eyes was 12% per year (p � 0.001). Additionally, each mm of corneal apex displacement from the pupillary center led to a 0.76 logMAR increase in visual acuity (p � 0.001). Conclusion. e presence of apical scarring and Fleischer rings on biomicroscopy can aid the clinician in making the distinction between severe or long-standing disease (respectively). Apical scarring is a sign of advanced disease and is associated with worse BSCVA and tomography findings. Fleischer rings are markers of intermediate disease and their presence correlates with disease duration.

Comparative Study of Macular Vascular Density and Retinal Thickness in Myopia Children with Different Microscope Diopters Based on OCTA

“…If we use the combination therapy method, when using atropine eye drops, and also use OK lens or myopia defocus treatment, the choroidal thickening will be greater, and the effect of myopia improvement will be more obvious. In addition, the levels of microvessel density in the surface and deep layers of macula in the three groups were gradually increased [14]. This suggests that myopia is closely related to the change of microvessel density in macula, that is, with the increasing degree of myopia, the microvessel density in macula also shows a corresponding change.…”

Post-FDA Approval Results of Epithelium-Off, Full-Fluence, Dresden Protocol Corneal Collagen Crosslinking in the USA

“…In this context, we found that eyes with preoperative apical scarring were more likely to show improvements in visual acuity by the last postoperative visit than those without apical scarring. This observation suggests that in eyes with apical scaring there may be more room for improvement in visual acuity after initial corneal remodeling [25][26][27].…”

Keratoconus Severity Detection From Elevation, Topography and Pachymetry Raw Data Using a Machine Learning Approach

“…rigid gas permeable contact lenses) [24]. Another possible solution involves the use of intracorneal rings which can contribute to the stabilization of keratoconus [25,26]. The adequate treatment must be conducted in accordance with the severity level and only under the recommendation of an ophthalmologist.…”