Keratokonus: Klinik, Diagnostik, Therapiemöglichkeiten

Bühren, Jens; Bischoff, Gudrun; Kohnen, Thomas

doi:10.1055/s-0031-1280224

Cited by 15 publications

(5 citation statements)

References 12 publications

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“…For example, associations with genetic disorders like Down’s syndrome [ 4 ] and influences of atopic dermatitis and eye rubbing have been described [ 5 ]. Keratoconus usually starts during adolescence and progresses until the third or fourth decade of life [ 6 , 7 ]. The CLEK (Collaborative Longitudinal Evaluation of Keratoconus) Study [ 8 ] showed a mean change in flatter keratometry readings of 1.6 dioptres in the natural course of keratoconus progression over an eight year period, where higher rates of progression occurred in younger than in older patients.…”

Section: Introductionmentioning

confidence: 99%

Prospective, randomized, double-blind trial to investigate the efficacy and safety of corneal cross-linking to halt the progression of keratoconus

et al. 2015

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BackgroundCorneal cross-linking is widely used to treat keratoconus. However, to date, only limited data from randomized trials support its efficacy.MethodsThe efficacy and safety of corneal cross-linking for halting progression of keratoconus were investigated in a prospective, randomized, blinded, placebo controlled, multicentre trial. Twenty-nine keratoconus patients were randomized in three trial centres. The mean age at inclusion was 28 years. Longitudinal changes in corneal refraction were assessed by linear regression. The best corrected visual acuity, surface defects and corneal inflammation were also assessed. These data were analysed with a multifactorial linear regression model.ResultsA total of 15 eyes were randomized to the treatment and 14 to the control group. Follow-up averaged 1098 days. Corneal refractive power decreased on average (+/−standard deviation) by 0.35 +/− 0.58 dioptres/year in the treatment group. The controls showed an increase of 0.11 +/− 0.61 dioptres/year. This difference was statistically significant (p = 0.02).ConclusionsOur data suggest that corneal cross-linking is an effective treatment for some patients to halt the progression of keratoconus. However, some of the treated patients still progressed, whereas some untreated controls improved. Therefore, further investigations are necessary to decide which patients require treatment and which do not.Trial registrationNCT00626717, Date of registration: February 20, 2008.

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Section: Introductionmentioning

confidence: 99%

Prospective, randomized, double-blind trial to investigate the efficacy and safety of corneal cross-linking to halt the progression of keratoconus

et al. 2015

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“…In präoperativen Kontrollen können ektatische Veränderungen der Hornhaut anhand von topografischen Mustern dargestellt werden. Eine für den Keratokonus typische Form wäre eine zentralisierte Sanduhrfigur mit abgeknickten Achsen [7]. Im Verlauf postoperativer Kontrollen können iatrogene Keratektasien diagnostiziert werden [8].…”

Section: Comparison Of Discriminant Analysis and Decision Trees For Tunclassified

Vergleich von Diskriminanzanalyse und Entscheidungsbäumen zur Erkennung des frühen Keratokonus

Kleinhans

Herrmann

Kohnen

et al. 2017

Klin Monatsbl Augenheilkd

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Iatrogenic keratectasia is one of the most dreaded complications of refractive surgery. In most cases, keratectasia develops after refractive surgery of eyes suffering from subclinical stages of keratoconus with few or no signs. Unfortunately, there has been no reliable procedure for the early detection of keratoconus. In this study, we used binary decision trees (recursive partitioning) to assess their suitability for discrimination between normal eyes and eyes with subclinical keratoconus. The method of decision tree analysis was compared with discriminant analysis which has shown good results in previous studies. Input data were 32 eyes of 32 patients with newly diagnosed keratoconus in the contralateral eye and preoperative data of 10 eyes of 5 patients with keratectasia after laser in-situ keratomileusis (LASIK). The control group was made up of 245 normal eyes after LASIK and 12-month follow-up without any signs of iatrogenic keratectasia. Decision trees gave better accuracy and specificity than did discriminant analysis. The sensitivity of decision trees was lower than the sensitivity of discriminant analysis. On the basis of the patient population of this study, decision trees did not prove to be superior to linear discriminant analysis for the detection of subclinical keratoconus.

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“…Vision-specific quality of life is significantly affected by keratoconus [ 3 ]. In most cases the disease is bilateral and mostly diagnosed in the second or third decade of life with an incidence of 55 : 100,000 [ 2 , 4 , 5 ].…”

Section: Introductionmentioning

confidence: 99%

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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Keratokonus: Klinik, Diagnostik, Therapiemöglichkeiten

Abstract: Geschützte Warennamen (Warenzeichen) werden nicht besonders kenntlich gemacht. Aus dem Fehlen eines solchen Hinweises kann also nicht geschlossen werden, dass es sich um einen freien Warennamen handelt.

Cited by 15 publications

References 12 publications

Prospective, randomized, double-blind trial to investigate the efficacy and safety of corneal cross-linking to halt the progression of keratoconus

Prospective, randomized, double-blind trial to investigate the efficacy and safety of corneal cross-linking to halt the progression of keratoconus

Vergleich von Diskriminanzanalyse und Entscheidungsbäumen zur Erkennung des frühen Keratokonus

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

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