The false positive rates for detecting keratoconus and potential ectatic corneal conditions when evaluating astigmatic eyes with Scheimpflug Technology

Henríquez, María A; Hadid, Marta G; Moctezuma, Cristobal; Izquierdo, Luis; Binder, Perry S.

doi:10.1177/11206721221081467

Cited by 4 publications

(2 citation statements)

References 56 publications

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“…Subklinický keratokónus podľa BAD/D Klinický keratokónus podľa BAD/D tacamu spojených s výskytom falošne pozitívnych výsledkov. V tejto štúdii taktiež výsledky celkovo ukázali, že miery falošne pozitívnych prípadov boli najvyššie v skupinách s hyperopickým astigmatizmom a zmiešaným astigmatizmom [12]. Toto vysvetľuje vysoké hodnoty BAD/D v skupine astigmatizmov v našom súbore.…”

Section: Subklinický Keratokónus Klinický Keratokónusunclassified

Use of Corneal Topography in Pediatric Ophthalmology

Popová,

Tomčíková,

Bušányová

et al. 2023

CSO

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Aim: To introduce the topic of pediatric keratoconus, highlighting the importance of routine corneal topography and tomography in children and adolescents from predisposed groups. To attempt to ensure the early detection of keratoconus and its subclinical form, enabling early treatment, which brings better expected postoperative results. Material and methods: Using the corneal tomograph Pentacam AXL we examined children and adolescents with astigmatism equal or greater than 2 diopters (in at least one eye) and patients with at least one risk factor such as eye rubbing in the case of allergic pathologies, positive family history of keratoconus or certain forms of retinal dystrophy. In total, we included 231 eyes (116 patients), of which 54 were girls and 62 were boys. Results: The Belin-Ambrósio deviation index parameter was evaluated, in which we classified a total of 41 eyes as subclinical keratoconus and 12 eyes as clinical keratoconus. Next, the corneal maps were evaluated individually, in which we included a total of 15 eyes as subclinical keratoconus and 6 eyes as clinical keratoconus. In our group, compared to the control group, subclinical and clinical keratoconus occurred most often in the group of patients with astigmatism and in the group of so-called “eye rubbers”. After individual evaluation, keratoconus occurred more frequently in boys than in girls in our cohort. Conclusion: Most patients with keratoconus are diagnosed when there is a deterioration of visual acuity and changes on the anterior surface of the cornea. Corneal topography and tomography allows us to monitor the initial changes on the posterior surface of the cornea, and helps us to detect the subclinical form of keratoconus and the possibility of its early treatment. Therefore, it is important to determine which groups are at risk and groups in which corneal topography and tomography should be performed routinely.

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Section: Subklinický Keratokónus Klinický Keratokónusunclassified

Use of Corneal Topography in Pediatric Ophthalmology

Popová,

Tomčíková,

Bušányová

et al. 2023

CSO

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“…The term “forme fruste” denotes an early manifestation of the disease lacking overt keratometric, retinoscopic, or slit lamp indications but exhibiting mild topographic changes [ 3 ]. These cases may mimic symptoms of high myopia, astigmatism, or amblyopia, making their differentiation from other refractive errors a clinical challenge [ 4 ].…”

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Diagnosis of forme fruste keratoconus with scheimpflug photography in Ghanaian patients

Lartey,

Appiagyei

2024

BMC Ophthalmol

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Aim This study aimed to differentiate moderate to high myopic astigmatism from forme fruste keratoconus using Pentacam parameters and develop a predictive model for early keratoconus detection. Methods We retrospectively analysed 196 eyes from 105 patients and compared Pentacam variables between myopic astigmatism (156 eyes) and forme fruste keratoconus (40 eyes) groups. Receiver operating characteristic curve analysis was used to determine the optimal cut-off values, and a logistic regression model was used to refine the diagnostic accuracy. Results Statistically significant differences were observed in most Pentacam variables between the groups (p < 0.05). Parameters such as the Index of Surface Variance (ISV), Keratoconus Index (KI), Belin/Ambrosio Deviation Display (BAD_D) and Back Elevation of the Thinnest Corneal Locale (B.Ele.Th) demonstrated promising discriminatory abilities, with BAD_D exhibiting the highest Area under the Curve. The logistic regression model achieved high sensitivity (92.5%), specificity (96.8%), accuracy (95.9%), and positive predictive value (88.1%). Conclusion The simultaneous evaluation of BAD_D, ISV, B.Ele.Th, and KI aids in identifying forme fruste keratoconus cases. Optimal cut-off points demonstrate acceptable sensitivity and specificity, emphasizing their clinical utility pending further refinement and validation across diverse demographics.

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Keratoconus Detection in High-Astigmatism Pediatric Patients: Optimal Pentacam Indices and Cutoff Points

Souza Oliveira,

Gil,

Rosa

et al. 2024

Cornea

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Purpose: To assess the accuracy of various Pentacam indices in distinguishing keratoconus (KC) in pediatric patients with high astigmatism and to establish appropriate cutoff values. Methods: This prospective multicenter cross-sectional study included 312 eyes from 167 patients aged 6 to 18 years (mean age, 13.1 ± 3.2 years) evaluated with Oculus Pentacam HR. Patients were categorized into 4 groups: KC, forme fruste keratoconus, astigmatism greater than 2 diopters (Cyl2D), and control. A subgroup of Cyl2D comprised patients with astigmatism greater than 4 diopters (Cyl4D). Twenty-three Pentacam indices were analyzed, and receiver operating characteristic curves determined optimal cutoff points, sensitivity, and specificity. Results: The best indices for distinguishing KC from Cyl2D were high-order aberration root mean square of the anterior corneal surface (area under the receiver operating characteristic curve 0.987), Belin/Ambrosio enhanced ectasia total derivation (0.971), index of vertical asymmetry (0.971), average pachymetric progression index (0.962), maximum Ambrosio relational thickness (0.960), posterior elevation (0.952), and anterior elevation (0.948). The accuracy of these indices was highest in the control group and lowest in the Cyl4D group. Area under the receiver operating characteristic curve was significantly lower for fruste keratoconus than KC. Optimal cutoff values were higher for astigmatic patients than for those with no refractive error. Conclusions: Most indices effectively distinguished between KC and normal pediatric patients. For individuals with high astigmatism, we suggest focusing on specific indices such as high-order aberration root mean square, Belin/Ambrosio enhanced ectasia total derivation value, maximum Ambrosio relational thickness, average pachymetric progression index, and index of vertical asymmetry. Optimal cutoff points for these patients were higher than those for nonastigmatic children and differed from adult populations.

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The false positive rates for detecting keratoconus and potential ectatic corneal conditions when evaluating astigmatic eyes with Scheimpflug Technology

Cited by 4 publications

References 56 publications

Use of Corneal Topography in Pediatric Ophthalmology

Use of Corneal Topography in Pediatric Ophthalmology

Diagnosis of forme fruste keratoconus with scheimpflug photography in Ghanaian patients

Keratoconus Detection in High-Astigmatism Pediatric Patients: Optimal Pentacam Indices and Cutoff Points

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