Role of Corneal Epithelial Measurements in Differentiating Eyes with Stable Keratoconus from Eyes that Are Progressing

Santhiago, Marcony R.; Stival, L; Araújo, Daniella Castro; Kara-Júnior, Newton; Toledo, Marcia C.

doi:10.1016/j.xops.2022.100256

Cited by 2 publications

(2 citation statements)

References 23 publications

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“…Epithelial measurements have recently been demonstrated to be useful in identifying eyes with KC that is actively progressing. TET and CET have also been repeatedly demonstrated to be effective in the diagnosis of keratoconus [ 19 ]. Temstet et al [ 33 ] and Toprak et al [ 41 ] both found out that TET may be a sensitive indicator for early keratoconus diagnosis.…”

Section: Discussionmentioning

confidence: 99%

“…Reinstein et al have suggested that a particular change of the epithelium in patients with keratoconus is an “epithelial doughnut pattern” [ 15 – 17 ]. It has been proposed that these changes can be used to evaluate the progression of the keratoconus disease because the epithelium can alter in response to the keratoconus disease [ 12 , 18 , 19 ].…”

Section: Introductionmentioning

confidence: 99%

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Assessing progression limits in different grades of keratoconus from a novel perspective: precision of measurements of the corneal epithelium

Ning,

Wang,

et al. 2024

Eye and Vis

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Background To assess repeatability and reproducibility of corneal epithelium thickness (ET) measured by a spectral-domain optical coherence tomographer (SD-OCT)/Placido topographer (MS-39, CSO, Florence, Italy) in keratoconus (KC) population at different stages, as well as to determine the progression limits for evaluating KC progression. Methods A total of 149 eyes were enrolled in this study, with 29 eyes in the forme fruste keratoconus (FFKC) group, 34 eyes in the mild KC group, 40 eyes in the moderate KC group, and 46 eyes in the severe KC group. Employing the within-subject standard deviation (Sw), test-retest variability (TRT), coefficient of variation (CoV), and intraclass correlation coefficient (ICC) to evaluate intraoperator repeatability and interoperator reproducibility. Results The repeatability and reproducibility of MS-39 in patients with KC were acceptable, according to ICC values ranging from 0.732 to 0.954. However, patients with more severe KC and progressive peripheralization of the measurement points had higher TRTs but a thinning trend. The current study tended to set the cut-off values of mild KC, moderate KC, and severe KC to 4.9 µm, 5.2 µm, and 7.4 µm for thinnest epithelium thickness (TET). When differences between follow-ups are higher than those values, progression of the disease is possible. As for center epithelium thickness (CET), cut-off values for mild KC, moderate KC, and severe KC should be 2.8 µm, 4.4 µm, and 5.3 µm. This might be useful in the follow-up and diagnosis of keratoconus. Conclusions This study demonstrated that the precision of MS-39 was reduced in measuring more severe KC patients and more peripheral corneal points. In determining disease progression, values should be differentiated between disease-related real changes and measurement inaccuracies. Due to the large difference in ET measured by MS-39 between various stages of disease progression, it is necessary to accurately grade KC patients to avoid errors in KC clinical decision-making.

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Section: Discussionmentioning

confidence: 99%