Can retinoscopy keep up in keratoconus diagnosis?

Goebels, S.; Käsmann‐Kellner, Barbara; Eppig, Timo; Seitz, Berthold; Langenbucher, Achim

doi:10.1016/j.clae.2015.01.015

Cited by 28 publications

(23 citation statements)

References 16 publications

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“…This suggests that biomechanical properties better reflect Pentacam than TMS-5 based keratoconus screening. This supports our previous findings [ 9 , 10 ].…”

Section: Discussionsupporting

confidence: 94%

Complementary Keratoconus Indices Based on Topographical Interpretation of Biomechanical Waveform Parameters: A Supplement to Established Keratoconus Indices

Goebels

Eppig

Wagenpfeil

et al. 2017

Computational and Mathematical Methods in Medicine

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Purpose. To build new models with the Ocular Response Analyzer (ORA) waveform parameters to create new indices analogous to established topographic keratoconus indices. Method. Biomechanical, tomographic, and topographic measurements of 505 eyes from the Homburger Keratoconus Centre were included. Thirty-seven waveform parameters (WF) were derived from the biomechanical measurement with the ORA. Area under curve (ROC, receiver operating characteristic) was used to quantify the screening performance. A logistic regression analysis was used to create two new keratoconus prediction models based on these waveform parameters to resample the clinically established keratoconus indices from Pentacam and TMS-5. Results. ROC curves show the best results for the waveform parameters p1area, p2area, h1, h2, dive1, mslew1, aspect1, aplhf, and dslope1. The new keratoconus prediction model to resample the Pentacam topographic keratoconus index (TKC) was WFTKC = −4.068 + 0.002 × p2area − 0.005 × dive1 − 0.01 × h1 − 2.501 × aplhf, which achieves a sensitivity of 90.3% and specificity of 89.4%; to resample the TMS-5 keratoconus classification index (KCI) it was WFKCI = −3.606 + 0.002 × p2area, which achieves a sensitivity of 75.4% and a specificity of 81.8%. Conclusion. In addition to the biomechanically provided Keratoconus Index two new indices which were based on the topographic gold standards (either Pentacam or TMS-5) were created. Of course, these do not replace the original topographic measurement.

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“…This suggests that biomechanical properties better reflect Pentacam than TMS-5 based keratoconus screening. This supports our previous findings [ 9 , 10 ].…”

Section: Discussionsupporting

confidence: 94%

Complementary Keratoconus Indices Based on Topographical Interpretation of Biomechanical Waveform Parameters: A Supplement to Established Keratoconus Indices

Goebels

Eppig

Wagenpfeil

et al. 2017

Computational and Mathematical Methods in Medicine

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“…5 Both early detection and final diagnosis require a complete eye exam and in-depth corneal assessment using different technologies, such as: 5,98,99 or when certain clinical signs are found in the eye exam, such as: scissors reflex during retinoscopy exam, "oil-droplet" reflex (Charleux sign), change in astigmatism refraction (in axe or power) or myopia increase with asymmetry between both eyes. 7,[100][101][102][103] In opposition, a definitive diagnose is usually done in specialist clinics, for example in cornea units, refractive surgery, etc. This practice requires establish keratoconus presence using the necessary techniques, which may be expensive but justifiable, such as: corneal tomography, AS-OCT and others devices that allow the characterisation of corneal biomechanical properties.…”

Section: Discussionmentioning

confidence: 99%

Keratoconus Screening in Primary Eye Care – A General Overview

Ortiz-Toquero¹,

Martín²

2016

European Ophthalmic Review

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Keratoconus early detection (screening) and diagnosis requires an in-deep corneal analysis with different techniques; slip lamp assessment, corneal topography and corneal tomography are the most commonly accepted to detect clinical signs and assess anterior and posterior corneal surface and global corneal pachymetry. However, keratoconus early detection and definitive diagnosis are two different clinical procedures that require a different approach and goals. The aim of this review is to provide some general information about different corneal assessment technology, useful in keratoconus patient assessment; highlighting the differences in the adequate investigation techniques to its detection in primary eye care clinic and to conduct the definitive diagnosis (usually in a cornea specialist clinic). Information of most extensively available commercial devices and the advantages and disadvantages of their use in keratoconus early detection and diagnosis are described. In conclusion, corneal topography (Placido-based keratographers) plays a significant role in keratoconus detection, especially in primary eye care clinics. However, corneal tomography (with different slit scanning and/or rotational imaging devices) including posterior corneal surface assessment and global corneal pachymetry investigation, is critical in definitive keratoconus diagnosis.

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“…Further, the Tomographic Keratoconus Classification (TKC) system provided by the Pentacam software (OCULUS Optikgerate GmbH, Wetzlar, Germany) was used for keratoconus classification as indicated in previous studies 30 , 31 . The TKC offers a classification system with 5 grades: 0 (normal) to 4 (severe keratoconus).…”

Section: Methodsmentioning

confidence: 99%

“…The TKC offers a classification system with 5 grades: 0 (normal) to 4 (severe keratoconus). Where in some cases intermediate grades (eg, 2–3) are displayed, the lower value was recorded 30 , 31 . Participants in the KC group had a TKC grade between 1 and 4, while members of the healthy group had a TKC grade of 0 in addition to satisfying the same gender and similar age conditions of match with the healthy group.…”

Section: Methodsmentioning

confidence: 99%

Repeatability of corneal elevation maps in keratoconus patients using the tomography matching method

Zheng

Huang

Zhao

et al. 2017

Sci Rep

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To assess repeatability of corneal tomography in successive measurements by Pentacam in keratoconus (KC) and normal eyes based on the Iterative Closest Point (ICP) algorithm. The study involved 143 keratoconic and 143 matched normal eyes. ICP algorithm was used to estimate six single and combined misalignment (CM) parameters, the root mean square (RMS) of the difference in elevation data pre (PreICP-RMS) and post (PosICP-RMS) tomography matching. Corneal keratometry, expressed in the form of M, J0 and J45 (power vector analysis parameters), was used to evaluate the effect of misalignment on corneal curvature measurements. The PreICP-RMS and PosICP-RMS were statistically higher (P < 0.01) in KC than normal eyes. CM increased significantly (p = 0.00), more in KC (16.76 ± 20.88 μm) than in normal eyes (5.43 ± 4.08 μm). PreICP-RMS, PosICP-RMS and CM were correlated with keratoconus grade (p < 0.05). Corneal astigmatism J0 was different (p = 0.01) for the second tomography measurements with misalignment consideration (−1.11 ± 2.35 D) or not (−1.18 ± 2.35 D), while M and J45 kept similar. KC corneas consistently show higher misalignments between successive tomography measurements and lower repeatability compared with healthy eyes. The influence of misalignment is evidently clearer in the estimation of astigmatism than spherical curvature. These higher errors appear correlated with KC progression.

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Can retinoscopy keep up in keratoconus diagnosis?

Cited by 28 publications

References 16 publications

Complementary Keratoconus Indices Based on Topographical Interpretation of Biomechanical Waveform Parameters: A Supplement to Established Keratoconus Indices

Complementary Keratoconus Indices Based on Topographical Interpretation of Biomechanical Waveform Parameters: A Supplement to Established Keratoconus Indices

Keratoconus Screening in Primary Eye Care – A General Overview

Repeatability of corneal elevation maps in keratoconus patients using the tomography matching method

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