Analysis of the diagnostic accuracy of Belin/Ambrósio Enhanced Ectasia and Corvis ST parameters for subclinical keratoconus

Song, Yaowen; Feng, Yan; Qu, Min; Ma, Qiuxia; Tian, Huiqin; Li, Dan; He, Rui

doi:10.1007/s10792-022-02543-8

Cited by 3 publications

(2 citation statements)

References 33 publications

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“…At 1.65, the false positive rate for even clinically manifest KCN is only 5% (32). Its validity as a screening tool has achieved widespread consensus (13,15,24,25,(33)(34)(35)(36), with area under the receiver operating characteristics curve (AUROC) for KCN ranging from 0.83-0.93 (13,15,21,31,(33)(34)(35). Even among SKCN and normal eyes, the BAD-D is replicable with low variations on repeat scans within a similar session (37).…”

Section: Discussionmentioning

confidence: 99%

Prevalence of subclinical keratoconus and impact on adults undergoing routine, uncomplicated age-related cataract extraction

Tran,

Mittal,

Naik

et al. 2023

Front. Ophthalmol.

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AimTo determine the prevalence of subclinical keratoconus (SKCN) among individuals undergoing routine, uncomplicated age-related cataract surgery and its impact on visual and refractive outcomes.Patient and MethodsAt a major academic ophthalmology department in the United States, we reviewed records of patients aged 50 years and older who underwent surgery from January 2011 to June 2022. We excluded patients who had poor-quality or unreliable tomographic data, previous corneal surgery, keratorefractive procedures, and significant vision-limiting ocular pathology. We defined SKCN if an eye had a Belin-Ambrósio enhanced ectasia index (BAD-D) ≥1.7, which was based on the results of a meta-analysis of large studies. In addition to the BAD-D cutoff, the eye had to deviate significantly on at least one of seven additional parameters: 1) posterior elevation at thinnest point, 2) index of vertical asymmetry, 3) index of surface variation, 4) total front higher order aberrations, 5) front vertical coma, 6) front secondary vertical coma, 7) back vertical coma. An individual had SKCN if at least one eye met the tomography-based classification and did not have manifest KCN in either eye. Visual and refractive outcomes data were acquired from patients of one experienced cataract surgeon with cases done from July 2021 to June 2022. Statistical significance was set at p < 0.05.ResultsAmong 5592 eyes from 3828 individuals, the prevalence of SKCN was 24.7% (95% CI, 23.4 – 26.1, 945 individuals), and the prevalence of KCN was 1.9% (95% CI, 1.6 – 2.4, 87 individuals). The prevalence of SKCN did not increase with age and was more prevalent among females and non-white races. Median post-operative month one distance-corrected visual acuity (DCVA) and proportion of eyes with improvement in DCVA were similar between normal and SKCN eyes. The proportion of eyes reaching ±0.5 and ±1.0 diopter within the refractive target were similar between normal and SKCN eyes.ConclusionSKCN is highly prevalent and should be detected but is unlikely to have a significant deleterious effect on outcomes in routine, uncomplicated cataract surgery.

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Section: Discussionmentioning

confidence: 99%

Prevalence of subclinical keratoconus and impact on adults undergoing routine, uncomplicated age-related cataract extraction

Tran,

Mittal,

Naik

et al. 2023

Front. Ophthalmol.

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“…The Scheimpflug-based corneal imaging such as Pentacam (Pentacam, OCULUS GmbH, Wetzlar, Germany) is a method that analyzes both anterior and posterior corneal elevation data and has become established for the diagnosis, grading and follow-up of KC [10][11][12][13]. The Belin/Ambrósio enhanced ectasia display (BAD) has been demonstrated to have a high sensitivity and is especially useful in the detection of early and subclinical KC [14,15]. BAD criteria include the standard deviation (SD) of mean changes in the anterior elevation (df), the SD of mean changes in the posterior elevation (db), the SD of the mean pachymetric progression (dp), the SD of the mean thinnest point thickness (dt), the SD of the mean thinnest point displacement (dy) and the D score, which is calculated by a regression analysis of five determinants [16].…”

Section: Introductionmentioning

confidence: 99%

Reduced Retinal Blood Vessel Densities Measured by Optical Coherence Tomography Angiography in Keratoconus Patients Are Negatively Correlated with Keratoconus Severity

Leclaire,

Storp,

Lahme

et al. 2024

Diagnostics

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Keratoconus (KC) is the most common corneal ectasia. Optical coherence tomography angiography (OCT-A) is a relatively new non-invasive imaging technique that allows the visualization and quantification of retinal and choriocapillary blood vessels. The aim of this study is to assess retinal and choriocapillary vessel density (VD) differences between KC patients and healthy controls and to investigate correlations between VD and KC severity. Fifty-two eyes were included in this exploratory study: twenty-six eyes from 26 KC patients and twenty-six eyes from 26 age- and gender-matched healthy controls. All patients underwent Scheimpflug corneal topography with Pentacam, axis lengths measurement and optical coherence tomography angiography (OCT-A). The thinnest spot in corneal pachymetry, maximum K (Kmax) and KC severity indices from the Belin/Ambrósio enhanced ectasia display (BAD) were also assessed. There was a distinct reduction particularly in the retinal VD of the superficial capillary plexus (SCP). Correlation analyses showed strong and moderate negative correlations between the VD in the macular SCP and BAD KC scores and between the SCP VD and Kmax. There was no difference in retinal thickness between the KC and healthy controls. With this study, further evidence for altered VD measurements by OCT-A in KC patients is given. For the first time, we demonstrated negative correlations between BAD KC scores and retinal blood vessel alterations. A major limitation of the study is the relatively small sample size. Since an artefactual reduction of the quantitative OCT-A measurements due to irregular corneal topography in KC must be assumed, it remains to be investigated whether there are also actual changes in the retinal microcirculation in KC.

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Performance of Corvis ST Parameters Including Updated Stress-Strain Index in Differentiating Between Normal, Forme-Fruste, Subclinical, and Clinical Keratoconic Eyes

Miao,

Ma,

et al. 2024

American Journal of Ophthalmology

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Analysis of the diagnostic accuracy of Belin/Ambrósio Enhanced Ectasia and Corvis ST parameters for subclinical keratoconus

Cited by 3 publications

References 33 publications

Prevalence of subclinical keratoconus and impact on adults undergoing routine, uncomplicated age-related cataract extraction

Prevalence of subclinical keratoconus and impact on adults undergoing routine, uncomplicated age-related cataract extraction

Reduced Retinal Blood Vessel Densities Measured by Optical Coherence Tomography Angiography in Keratoconus Patients Are Negatively Correlated with Keratoconus Severity

Performance of Corvis ST Parameters Including Updated Stress-Strain Index in Differentiating Between Normal, Forme-Fruste, Subclinical, and Clinical Keratoconic Eyes

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