Quantitative Evaluation of the Natural Progression of Keratoconus Using Three-Dimensional Optical Coherence Tomography

Fujimoto, Hisataka; Maeda, Naoyuki; Shintani, Ayumi; Nakagawa, Tomoya; Fuchihata, Mutsumi; Higashiura, Ritsuko; Nishida, Kohji

doi:10.1167/iovs.15-18650

Cited by 37 publications

(23 citation statements)

References 30 publications

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“…Moreover, there were no eyes with Rmin > 6.53 mm (equivalent to 51.7 D) required CXL in this age group ( Fig 2). Some researchers have suggested that keratoconus may progress even beyond 30 years of age [16][17][18]; however, they did not categorize patients with respect to the Rmin value at baseline. The present results indicate that mild to moderate keratoconus at the age of 27 years or older should be followed-up; however, frequent follow-up visits are not necessary.…”

Section: Plos Onementioning

confidence: 99%

“…The present results indicate that mild to moderate keratoconus at the age of 27 years or older should be followed-up; however, frequent follow-up visits are not necessary. Eyes with severe keratoconus (especially with a Rmin � 6.73 mm [58.9 D]) should be followed-up closely, even beyond the age of 27 years, as these patients may also develop acute hydrops [17].…”

Section: Plos Onementioning

confidence: 99%

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Baseline factors predicting the need for corneal crosslinking in patients with keratoconus

et al. 2020

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Introduction The primary purpose of crosslinking is to halt the progression of ectasia. We retrospectively assessed the condition of keratoconus patients who were followed-up at least twice after the initial examination to evaluate keratoconus progression, to identify definitive factors to predict a later need for corneal crosslinking (CXL). Methods The medical charts of 158 eyes of 158 keratoconus patients (112 males and 46 females; mean age, 27.8 ± 11.7 years), who were followed up at the Department of Ophthalmology, Keio University School of Medicine at least twice after the initial examination to evaluate keratoconus progression were retrospectively reviewed. Best-spectacle corrected visual acuity, intraocular pressure, steepest corneal axis on the anterior float (Ks), thinnest corneal thickness according to Pentacam ® HR, and corneal endothelial cell density were assessed. Gender, age, onset age of keratoconus, history of atopic dermatitis, and Pentacam ® indices were also recorded. CXL was performed when the eye showed significant keratoconus progression, an increase in the steepest keratometric value, or an increase in the spherical equivalent or cylinder power of the manifest refraction by more than 1.0 D versus the respective values 2 years prior. Predictor variables and the requirement for CXL were analyzed using logistic regression. Results Fifty-eight eyes required CXL treatment. The best predictor of the requirement for CXL was patient age, followed by the Pentacam ® Rmin (the minimum sagittal curvature evaluated by Pentacam ®) value. The incidence of CXL was 86.4% in the < 20 years age group, with an Rmin of � 5.73 mm, whereas 10.8% in the � 27 years age group with an Rmin > 5.73 mm underwent treatment.

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Section: Plos Onementioning

confidence: 99%

Section: Plos Onementioning

confidence: 99%

Baseline factors predicting the need for corneal crosslinking in patients with keratoconus

et al. 2020

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“…[14][15][16] Clinical keratoconus is reliably detected with Placido disk-based corneal topography and even sometimes at slit-lamp examination. 16 Other technologies, such as: corneal tomography (Scheimpflug or dual Scheimpflug devices), 3,13,17 anterior segment optical coherence tomography (AS-OCT), 18,19 biomechanical devices 20,21 that analyse the anterior and posterior corneal surface, full corneal thickness map, epithelial mapping, or corneal biomechanical properties are necessary to complete keratoconus diagnosis. 5,22 Currently, there is no clinically accepted classification allowing eyecare practitioners to clearly differentiate between healthy and keratoconus cornea (especially in early stages), and that could be used in patients' follow-up in suspect (or diagnosed) cases.…”

Section: Keratoconus Detection Diagnosis and Classificationmentioning

confidence: 99%

“…64,65 AS-OCT has been proposed to assess keratoconus patients ( Figure 4); 66 helping to investigate corneal thickness asymmetry, 67 epithelial thickness-distribution characteristics 68 and monitoring progression. 19 AS-OCT could be a promise tool in keratoconus diagnosis (helping to differentiate between fustre and clinical forms of keratoconus of healthy corneas).…”

Section: Corneal Tomographymentioning

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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“…Periodic corneal shape monitoring is currently the main method adopted to determine the progression of corneal thinning and protrusion in KC, and the effectiveness of management techniques such as collagen cross-linking (CXL) and rigid gas permeable lens wear in halting progression. Various corneal shape measurement methods exist including the Placido 4 , 5 , Scheimpflug 6 , 7 , and Optical coherence tomography (OCT) 8 , 9 , all of which need to comply with strict repeatability criteria in order to provide reliable information on progression. Here the typically irregular surface of the keratoconic cornea presents a difficult challenge to achieving good repeatability of tomography measurements.…”

Section: Introductionmentioning

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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Quantitative Evaluation of the Natural Progression of Keratoconus Using Three-Dimensional Optical Coherence Tomography

Cited by 37 publications

References 30 publications

Baseline factors predicting the need for corneal crosslinking in patients with keratoconus

Baseline factors predicting the need for corneal crosslinking in patients with keratoconus

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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