Recent developments in keratoconus diagnosis

Salomão, Marcella Q.; Höffling-Lima, Ana Luisa; Lopes, Bernardo; Belin, Michael W.; Sena, Nelson; Dawson, Daniel G.; Ambrósio, Renato

doi:10.1080/17469899.2018.1555036

Cited by 37 publications

(29 citation statements)

References 98 publications

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“…is wide range of reported estimates may be due to ethnic differences, differences in accessibility because of regional differences, and discordant study designs [3]. Additionally, with recent advances in refractive surgery and the development of delicate corneal topographic devices and software, keratoconus is diagnosed more frequently than before, especially in the early subclinical stages, which may also account for some disparities in the estimates of annual incidence of keratoconus [4,5].…”

Section: Introductionmentioning

confidence: 99%

Incidence of Keratoconus and Its Association with Systemic Comorbid Conditions: A Nationwide Cohort Study from South Korea

Moon

Lee

Park

et al. 2020

Journal of Ophthalmology

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Purpose. To determine the incidence of keratoconus and to determine its possible association with common systemic diseases using a nationwide cohort. Methods. This retrospective nationwide cohort study included 1,025,340 subjects from the Korean National Health Insurance Service-National Sample Cohort database from 2004 to 2013. Estimates for incidence rates of keratoconus were identified. After 1 : 5 matching using propensity scores, associations between keratoconus and certain systemic comorbidities were determined using multivariate logistic regression analysis. Results. The incidence during the same period was 15.1 cases per 100,000 person-years. Adjusted logistic regression analysis after propensity score matching revealed significant associations between keratoconus and allergic rhinitis (odds ratio (OR): 1.86; 95% confidence interval (CI): 1.63–2.13; p<0.001), asthma (OR: 1.20; 95% CI: 1.06–1.36; p<0.001), atopic dermatitis (OR: 1.33; 95% CI: 1.13–1.56; p<0.001), and diabetes mellitus (DM) (OR: 1.35; 95% CI: 1.15–1.58; p<0.001). Conclusion. Estimates of the incidence of keratoconus may help in the planning of eye-care policies, and the results of this study determined the associations between allergic diseases and keratoconus. Conflicting results regarding the association between keratoconus and DM should be further evaluated.

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Section: Introductionmentioning

confidence: 99%

Incidence of Keratoconus and Its Association with Systemic Comorbid Conditions: A Nationwide Cohort Study from South Korea

Moon

Lee

Park

et al. 2020

Journal of Ophthalmology

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“…On the subject of ectatic corneal diseases, such as keratoconus (KC), and pellucid marginal degeneration, knowledge of corneal biomechanics offers a significant contribution and relevance for the diagnosis, staging, and prognosis of the disease [12][13][14]. Understanding the cornea's biomechanical behavior is relevant for the detection of subclinical KC as well as for detection of ectasia progression, while changes in topography are still insufficient to provide conclusive evidence [15].…”

Section: Clinical Applications Of Corneal Biomechanicsmentioning

confidence: 99%

“…Biomechanics cannot be assessed from a single image without a perturbation of some kind. The concept of multimodal corneal imaging was introduced to pivot the many diagnostic tools available [14]. Placido disk-based corneal topography has been proven to improve the ability to detect abnormalities of mild corneal ectasia in patients with normal distance-corrected visual acuity and unremarkable slit lamp examinations [13,19,20].…”

Section: Evolution Of Corneal Imaging and Characterizationmentioning

confidence: 99%

“…Placido disk-based corneal topography has been proven to improve the ability to detect abnormalities of mild corneal ectasia in patients with normal distance-corrected visual acuity and unremarkable slit lamp examinations [13,19,20]. Subsequently, the advent of anterior segment tomography, with the 3-dimensional reconstruction of the cornea, provided more detail about corneal architecture with a variety of quantitative indices derived from the front and back elevation and the pachymetric maps [3,14,21,22]. The ability of corneal tomography to further enhance the accuracy of detecting mild or subclinical ectatic disease was demonstrated in different studies involving eyes with typically normal topography from patients with clinical ectasia identified in the fellow eye [13,[23][24][25][26][27][28].…”

Section: Evolution Of Corneal Imaging and Characterizationmentioning

confidence: 99%

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Biomechanical diagnostics of the cornea

et al. 2020

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Corneal biomechanics has been a hot topic for research in contemporary ophthalmology due to its prospective applications in diagnosis, management, and treatment of several clinical conditions, including glaucoma, elective keratorefractive surgery, and different corneal diseases. The clinical biomechanical investigation has become of great importance in the setting of refractive surgery to identify patients at higher risk of developing iatrogenic ectasia after laser vision correction. This review discusses the latest developments in the detection of corneal ectatic diseases. These developments should be considered in conjunction with multimodal corneal and refractive imaging, including Placido-disk based corneal topography, Scheimpflug corneal tomography, anterior segment tomography, spectral-domain optical coherence tomography (SD-OCT), very-high-frequency ultrasound (VHF-US), ocular biometry, and ocular wavefront measurements. The ocular response analyzer (ORA) and the Corvis ST are non-contact tonometry systems that provide a clinical corneal biomechanical assessment. More recently, Brillouin optical microscopy has been demonstrated to provide in vivo biomechanical measurements. The integration of tomographic and biomechanical data into artificial intelligence techniques has demonstrated the ability to increase the accuracy to detect ectatic disease and characterize the inherent susceptibility for biomechanical failure and ectasia progression, which is a severe complication after laser vision correction.

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“…Corneal biomechanical determination is of great importance in clinical evaluation, such as diagnosis of keratoconus 1 , assessment before corneal refractive surgery 2,3 , and measurement of corrected intraocular pressure 4,5 . In recent years, various instruments that measured corneal biomechanics appeared, such as ocular response analyzer (ORA) and Corvis ST.…”

Section: Introductionmentioning

confidence: 99%

Age Distribution and Associated Factors of Cornea Biochemical Parameter Stress-Strain Index in Chinese Healthy Population

Liu

Hua

Pei

et al. 2020

Preprint

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Background: To investigate the new cornea biochemical parameter stress-strain index (SSI) in Chinese healthy people and the factors associated with SSIMethods: A total of 175 eyes from 175 participants were recruited in this study. Axial length was measured with the Lenstar LS-900. Pentacam was used to measure curvature of the cornea and ACV and cornea biomechanical properties were measured by corneal visualization Scheimpflug technology (Corvis ST). Student’s t-test, one-way ANOVA, univariate and multivariate linear regression were used in the statistical analysis.Results: The mean (±SD) SSI was 1.14 ± 0.22 (range, 0.66–1.78) in all subjects and affected by age significantly after age of 35 (P < 0.05). In univariate regression models, SSI did not vary with biomechanical intraocular pressure (bIOP) (P=0.989), steepest radius of anterior corneal curvature (RsF) (P=0.984) or central corneal thickness (CCT) (P=0.651). In multivariate regression models, SSI was significantly associated with age (β=0.557, P<0.001), axial length (AL) (β=-0.550, P<0.001), intraocular pressure (IOP) (β=0.377, P<0.001) and flattest radius of anterior corneal curvature (RfF) (β=0.222, P<0.001) but not with anterior chamber volume (ACV).Conclusions: SSI was increased by age after the age of 35. In addition to age, SSI and RfF, IOP is positively correlated and negatively correlated with AL.

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Recent developments in keratoconus diagnosis

Cited by 37 publications

References 98 publications

Incidence of Keratoconus and Its Association with Systemic Comorbid Conditions: A Nationwide Cohort Study from South Korea

Incidence of Keratoconus and Its Association with Systemic Comorbid Conditions: A Nationwide Cohort Study from South Korea

Biomechanical diagnostics of the cornea

Age Distribution and Associated Factors of Cornea Biochemical Parameter Stress-Strain Index in Chinese Healthy Population

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