Validation of an Objective Scoring System for Forme Fruste Keratoconus Detection and Post-LASIK Ectasia Risk Assessment in Asian Eyes

Chan, Cordelia; Ang, Marcus; Saad, Alain; Chua, Daniel; Mejia, Melissa Camila Correa; Lim, Louis W.; Gatinel, Damien

doi:10.1097/ico.0000000000000529

Cited by 68 publications

(53 citation statements)

References 33 publications

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“…For example, accurate corneal imaging is important before offering corneal refractive procedures such as laser in situ keratomileusis,64 or even newer forms such as refractive lenticule extraction,65 as such eyes are at higher risk of developing ectasia with greater amounts of corneal ablation 66. Precise anterior segment imaging is also required for planning safe phakic lens implantation, which are more likely to be performed in high myopes that are unsuitable for laser refractive correction 67.…”

Section: Introductionmentioning

confidence: 99%

Imaging in myopia: potential biomarkers, current challenges and future developments

et al. 2019

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Myopia is rapidly increasing in Asia and around the world, while it is recognised that complications from high myopia may cause significant visual impairment. Thus, imaging the myopic eye is important for the diagnosis of sight-threatening complications, monitoring of disease progression and evaluation of treatments. For example, recent advances in high-resolution imaging using optical coherence tomography may delineate early myopic macula pathology, optical coherence tomography angiography may aid early choroidal neovascularisation detection, while multimodal imaging is important for monitoring treatment response. However, imaging the eye with high myopia accurately has its challenges and limitations, which are important for clinicians to understand in order to choose the best imaging modality and interpret the images accurately. In this review, we present the current imaging modalities available from the anterior to posterior segment of the myopic eye, including the optic nerve. We summarise the clinical indications, image interpretation and future developments that may overcome current technological limitations. We also discuss potential biomarkers for myopic progression or development of complications, including basement membrane defects, and choroidal atrophy or choroidal thickness measurements. Finally, we present future developments in the field of myopia imaging, such as photoacoustic imaging and corneal or scleral biomechanics, which may lead to innovative treatment modalities for myopia.

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Section: Introductionmentioning

confidence: 99%

Imaging in myopia: potential biomarkers, current challenges and future developments

et al. 2019

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Section: Discussionmentioning

confidence: 99%

“…Screening of FFKC is vital so that such corneas can be eliminated from potential risks of ectasia as a result of intervention . Morphological changes in KC eyes such as thinning and steepening have been characterized extensively in several studies but only a few of them have assessed both FFKC and KC eyes . A classification system, using anterior corneal surface aberrations and Orbscan IIz topographer (Bausch & Lomb, New York, USA), reported nearly 100% sensitivity but a widely varying specificity ranging from 68% to 97% in detection of FFKC eyes .…”

Section: Discussionmentioning

confidence: 99%

“…However, assessment of the fellow eye in asymmetric KC subjects is a challenging task as the progression of the disease can last over several years . Serial follow‐up of the patient is required to assess the true onset of KC . These eyes may be classified as forme fruste keratoconus or FFKC .…”

Section: Introductionmentioning

confidence: 99%

“…These eyes may be classified as forme fruste keratoconus or FFKC . Based on corneal tomography, several detection scores have been developed for diagnosis of FFKC eyes . However, these scores are almost entirely dependent on the measurement device since they differ in resolution and accuracy .…”

Section: Introductionmentioning

confidence: 99%

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Application of high resolution OCT to evaluate irregularity of Bowman's layer in asymmetric keratoconus

Pahuja

Shroff

Pahanpate

et al. 2016

Journal of Biophotonics

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Irregularity of the Bowman's layer (BL) in keratoconus (KC, sample size (n) = 28) and forme fruste keratoconus (FFKC, n = 18) eyes was evaluated. Subjects underwent high resolution OCT imaging (Bioptigen Inc., USA) and corneal tomography (Pentacam v1.20r41, OCULUS Optikgeräte GmbH, Germany). Anterior edge of the BL was segmented. A Bowman's roughness index (BRI) was defined as the sum of the enclosed areas between segmented edge and a smooth 3 order polynomial fit to the edge. BRI was compared with corneal aberrations, Keratoconus percentage index (KISA), Cone location magnitude index (CLMI) and Belin-Ambrosio enhanced ectasia display overall deviation index (BAD-D). Area under the curve (AUC) was determined with logistic regression (LR). Mean BRI (×10 ) was 2.12 mm , 1.81 mm and 1.7 mm in normal (n = 26), FFKC and KC eyes, respectively (p < 0.001). BAD-D (0.79) and BRI (0.74) had the best AUC for FFKC. By combining BAD-D and BRI, the AUC improved to 0.85 (p = 0.01). For KC eyes, KISA (0.94), CLMI (0.88), BAD-D (0.96) and aberrations had comparable AUC (p > 0.05). However, LR with BRI and other indices didn't improve the AUC in KC eyes (p > 0.05). BRI was significantly reduced in FFKC and KC eyes. It improved the detection of FFKC but not KC eyes.

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Artificial intelligence for detecting keratoconus

Vandevenne,

Favuzza,

Veta

et al. 2023

Cochrane Database of Systematic Reviews

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Validation of an Objective Scoring System for Forme Fruste Keratoconus Detection and Post-LASIK Ectasia Risk Assessment in Asian Eyes

Abstract: The SCORE Analyzer algorithm, developed and validated in eyes of white subjects, was found to be valid and consistent in Asian eyes, showing good sensitivity and specificity in FFKC detection, and to be useful in objectively identifying cases at risk of post-LASIK keratectasia.

Cited by 68 publications

References 33 publications

Imaging in myopia: potential biomarkers, current challenges and future developments

Imaging in myopia: potential biomarkers, current challenges and future developments

Application of high resolution OCT to evaluate irregularity of Bowman's layer in asymmetric keratoconus

Artificial intelligence for detecting keratoconus

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