Ectatic diseases

Salomão, Marcella Q.; Hofling-Lima, Ana Luísa; Esporcatte, Louise Pellegrino Gomes; Correa, Fernando Faria-; Lopes, Bernardo; Sena, Nelson; Dawson, Daniel G.; Ambrósio, Renato

doi:10.1016/j.exer.2020.108347

Cited by 33 publications

(33 citation statements)

References 118 publications

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“…In this context, it would be interesting to compare the reported diagnostic power with that from the PRFI. 6 , 22 , 33 …”

Section: Discussionmentioning

confidence: 99%

“…All of the patients were diagnosed by a cornea specialist in a tertiary center. 22 Subclinical keratoconus—Contralateral, asymptomatic eye showing no clinical signs of ectasia of a subject with clinical ectasia in the other eye as a very or highly asymmetric ectasia. 22 These eyes had central average keratometry < 47.2 diopter, KISA% < 100% (18 out of 20 KISA% < 60%), 23 and normal scores for topographical keratoconus classification and ABCD (A0B0C0).…”

Section: Methodsmentioning

confidence: 99%

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Detection of Subclinical Keratoconus With a Validated Alternative Method to Corneal Densitometry

Consejo

Jiménez‐García

Issarti

et al. 2021

Trans. Vis. Sci. Tech.

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Purpose To enhance the current standards of subclinical keratoconus screening based on the statistical modeling of the pixel intensity distribution of Scheimpflug images. Methods Scheimpflug corneal tomographies corresponding to 25 corneal meridians of 60 participants were retrospectively collected and divided into three groups: controls (20 eyes), subclinical keratoconus (20 eyes), and clinical keratoconus (20 eyes). Only right eyes were selected. After corneal segmentation, pixel intensities of the stromal tissue were statistically modeled using a Weibull probability density function from which parameter α (pixel brightness) was derived. Further, data were transformed to polar coordinates, smoothed, and interpolated to build a map of the corneal α parameter. The discriminative power of the method was analyzed using receiver operating characteristic curves. Results The proposed platform-independent method achieved a higher performance in discriminating subclinical keratoconus from control eyes (90.0% sensitivity, 95.0% specificity, 0.97 area under the curve [AUC]) than the standard method (Belin–Ambrósio enhanced ectasia display), which uses only corneal morphometry (85.0% sensitivity, 85.0% specificity, 0.80 AUC). Conclusions Analysis of light backscatter at the cornea successfully discriminates subclinical keratoconus from control eyes, upgrading the results previously reported in the literature. Translational Relevance The proposed methodology has the potential to support clinicians in the detection of keratoconus before showing clinical signs.

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“…In this context, it would be interesting to compare the reported diagnostic power with that from the PRFI. 6 , 22 , 33 …”

Section: Discussionmentioning

confidence: 99%

Section: Methodsmentioning

confidence: 99%

Detection of Subclinical Keratoconus With a Validated Alternative Method to Corneal Densitometry

Consejo

Jiménez‐García

Issarti

et al. 2021

Trans. Vis. Sci. Tech.

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Section: Introductionmentioning

confidence: 99%

“…Keratoconus (KC), the most common form of corneal ectasia, is characterised by progressive visual disability and stromal thinning 1,2 . The pathogenesis of KC can be roughly explained by complex interactions between genetic and environmental factors, 1,2 whereas the molecular pathways underlying its pathogenesis remain unclear. Family history, ethnicity, geographical and cultural factors such as endogamy and consanguinity, eye rubbing, atopy, contact lens usage and floppy eyelid syndrome are factors implicated in development and progression of KC 1–3 .…”

Section: Introductionmentioning

confidence: 99%

“…The pathogenesis of KC can be roughly explained by complex interactions between genetic and environmental factors, 1,2 whereas the molecular pathways underlying its pathogenesis remain unclear. Family history, ethnicity, geographical and cultural factors such as endogamy and consanguinity, eye rubbing, atopy, contact lens usage and floppy eyelid syndrome are factors implicated in development and progression of KC 1–3 . Although the corneal stroma is the main site of impact, the pathological mechanisms are not confined to the stroma.…”

Section: Introductionmentioning

confidence: 99%

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Increased epithelial backscatter: A novel finding in subclinical and clinical keratoconus

Toprak

Güneş

2021

Clinical Exper Ophthalmology

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Background To assess alterations in backscatter from the corneal epithelium, anterior stroma and lens surface in eyes with subclinical, mild and moderate keratoconus (KC). Methods In this single‐centre, cross‐sectional study involving 24 eyes with subclinical KC, 107 eyes with manifest KC (mild = 40 and moderate = 67 eyes) and 90 controls, line densitometry was performed with Pentacam (Oculus Optikgeräte GmbH, Wetzlar, Germany) to obtain simultaneous backscatter values for the corneal epithelium, anterior stroma and anterior lens surface. Backscatter values and Pentacam parameters were used in subsequent statistical analyses. Results Eyes with subclinical, mild and moderate KC had similar epithelial and stromal backscatter (P > 0.05) that was significantly increased compared with the controls (P < 0.05). Although anterior lens surface backscatter did not differ between the control and KC groups (P > 0.05), it was significantly higher in the mild and moderate KC groups than in the subclinical KC group (P < 0.05). In the KC group (n = 131) epithelial backscatter was strongly correlated with stromal backscatter (r = 0.911, P < 0.0001). Conclusions Increased epithelial backscatter and a strong correlation with anterior stromal backscatter in the KC groups were consistent with the epithelium‐stroma interaction involved in KC pathogenesis. Single‐point backscatter analysis can be used with point clouds to construct epithelial and stromal backscatter maps in Pentacam to aid the detection of KC as a novel feature.

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