The average flat meridian keratometry was (K1) 46.7 ± 5.89 D; the average steep keratometry (K2) was 51.05 ± 6.59 D. The index of surface variance and the index of height decentration had the strongest correlation with topographic keratoconus grading (P < 0.001). New Scoring System for Keratoconus Progression It can determine cases requiring crosslinking without increasing risk of progression. Usually both eyes are affected. PubMed Central  2015;4(3):55–63. Rabinowitz YS, Nesburn AB, McDonnell PJ. The use of these parameters in addition to the ABCD grading system should offer an improved method of classifying and grading keratoconus and assist in documenting progression of disease. Because all three parameters are centered on the thinnest point (surrogate for center of the cone) and limited to the conical region, they should reflect change earlier than more global parameters (e.g. London: J Churchill; 1854. Schematic of axial topography including a sample topography of the left eye. With this information, both corneal thickness and anterior chamber depth can be computed. This allows us to separate measurement variance from true change. Expanding the cone location and magnitude index to include corneal thickness and posterior surface information for the detection of keratoconus. Gilani F, Cortese M, Ambrósio Jr RR, Lopes B, Ramos I, Harvey EM, et al. Variables used for keratoconus detection showed a weak correlation with each other (eg, correlation r=0.245 between RPImin and Kmax, p<0.001). Michael W Belin is a consultant to OCULUS GmbH. Use of the new clinical scoring system also was associated with an overall reduced rate of crosslinking (… Sensitivity and specificity of posterior corneal elevation measured by Pentacam in discriminating keratoconus/subclinical keratoconus. Surv Ophthalmol. J Refract Surg. 1). Weed KH, McGhee CN, Mac Ewen CJ. Google Scholar. 1986;101:267–73. Rabinowitz YS. J Cataract Refract Surg. Early ectatic change is typically seen on the posterior corneal surface prior to anterior changes (Fig. Correlation of topometric and tomographic indices with visual acuity in patients with keratoconus. Pre-vious studies have defined the progression of keratoconus with diverse parameters, from the clinical progression that necessitates penetrating keratoplasty to several topograph-ic indices. Manage cookies/Do not sell my data we use in the preference centre. He is responsible for development of protocols on keratoconus monitoring and progression criteria and is actively involved in research into the effectiveness of both new and existing treatments for the condition. Kanellopoulos et al. Various keratoconus diagnosis, staging, and progression crite-ria are in clinical use. Caption: Figure 1. 1998;42:297–319. Chatzis N, Hafezi F. Progression of keratoconus and efficacy of pediatric corneal collagen cross-linking in children and adolescents. Introduction Keratoconus is a clinical term used to describe a condition in which the cornea assumes a conical shape as a result of non- inflammatory thinning and protrusion. Aim: To define variables for the evaluation of keratoconus progression and to determine cut-off values. 2015;2015:925414. Part of 2005;28:177–9. Barbara R, Castillo JH, Hanna R, Berkowitz E, Tiosano B, Barbara A. Keratoconus Expert Meeting, London, 2014. 2014 Apr;98(4):459-63. doi: 10.1136/bjophthalmol-2013-304132. PubMed Central  criteria in mak ing an ea rly diagnosis and assessi ng pro- gression in keratoconus patients. Outcomes of Corneal Topography among Progressive Keratoconus Patients 12 months following Corneal Collagen Cross-Linking Javascript is currently disabled in your browser. Ophthalmology. Longitudinal study of keratoconus progression. The Amsler-Krumeich (AK) system is amongst the oldest and still the most widely used. The criteria used to define keratoconus progression were satisfactory when compared to inter-session reliability of corneal parameters. Exclusion criteria included past ocular surgery, recent rigid contact lens wear, and corneal scarring. Terms and Conditions, Keratoconus is a non‐inflammatory corneal ectasia characterised by apical thinning, irregular astigmatism and central scarring of the cornea. Criteria can include data from clinical evaluation and topography- and topometry-derived indicators. One or more … Krachmer JH, Feder RS, Belin MW. In 2015, a global Delphi panel published a consensus report recognizing cross-linking as the standard of care for progressive keratoconus. Belin MW, Kim J, Zloty P, Ambrósio Jr R. Simplified nomenclature for describing keratoconus. While the Best-Fit-Sphere (BFS) is both quantitatively and qualitatively useful, the clinician typically assumes that the reference surface closely approximates a “normal” cornea. Article  In this retrospective cohort study (2010-2016), 265 eyes of 165 patients diagnosed with keratoconus underwent two Scheimpflug measurements (Pentacam) that took place 1 year apart ±3 months. Several classification systems for keratoconus have been proposed in the literature [11–19]. Ophtalmologica. Fourier-domain optical coherence tomography imaging in keratoconus: a corneal structural classification. Cornea. J Cataract Refract Surg. Keratoconus. Keratoconus eyes showed anterior apex and maximum elevation changes of 20.4±23.1µm and 20.9±21.9µm. J Cataract Refract Surg. Several features of this site will not function whilst javascript is disabled. eCollection 2020 Jul. Eye Contact Lens. 2012;28(12):890–4. J Refract Surg. Eye refraction. [14, 42, 46–48]. Excluding this zone from the standard 8 mm BFS results in a reference surface that closely mimics the more normal portions of the cornea. © Author(s) (or their employer(s)) 2019. Br J Ophthalmol. 2013;61(8):401–6. Aim: 4). Keratoconus causes increasing blurriness and shortsightedness in vision, light sensitivity and halos and ghosting around light sources. Open Access This article is distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made. Round and oval cones in keratoconus. Videokeratography of the fellow eye in unilateral keratoconus. Keratoconus is relatively uncommon with a reported annual incidence of 2 per 100,000 and prevalence of 54.5 per 100,000, though rates vary greatly in different geographic regions [5, 6, 7]. Med Arch. Nottingham J. 2006;25:794–800. Kmax fails to reflect the degree of ectasia, ignores the contribution of the posterior cornea to progression and marked ectatic progression can occur with no change or even a reduction in Kmax [32–34]. Keratoconus was first described in detail in 1854 as a chronic, non-inflammatory ectasia of the cornea. It is indicated for patients with progressive keratoconus or ectasia because it offers the opportunity to preserve visual function by slowing or halting progression of the condition. Identifying progression of subclinical keratoconus by serial topography analysis. The disease may be highly asymmetric [8, 9] and ocular symptoms and signs of keratoconus vary depending on disease severity. Kanellopoulos AJ, Moustou V, Asimellis G. Evaluation of visual acuity, pachymetry and anterior-surface irregularity in keratoconus and crosslinking intervention follow-up in 737 cases. As earlier noted, according to Global Consensus on Keratoconus and Ectatic Diseases (2015), there is no consistent or clear definition of ectasia progression [23]. Eye and Vis 3, 6 (2016). 1) [33]. J Cataract Refract Surg. Ophthalmology. Song P, Yang K, Li P, Liu Y, Liang D, Ren S, Zeng Q. Biomed Res Int. 2008;24(6):606–9. Google Scholar. Ophthalmology. The 95 % and 80 % one-sided confidence intervals for all three parameters were surprisingly small (7.88/4.03 μm for corneal thickness, 0.024/0.012 mm for ARC, and 0.083/0.042 mm for PRC), suggesting that they may perform well as progression determinants. 2014;3(1):1–8. To define variables for the evaluation of keratoconus progression and to determine cut-off values. Belin MW, Duncan JK. 22 In a longitudinal study, Li et al identified videokeratographic indices predictive . [Corneal topography and keratoconus diagnostics with Scheimpflug photography].  |  Keratoconus eys showed posterior apex and maximum elevation changes of 39.9±38.1µm and 45.7±35.9µm. Diagnosis of keratoconus progression by Fourier-domain optical coherence tomography should be correlated with Scheimpflug tomography. A table listing the criteria for keratoconus progression in previous studies was generated. Receiver-operating characteristic curve (ROC) analysis was performed and Youden Index calculated to determine cut-off values. Ultrasound pachymetry can also be used to measure the thinnest zone on the cornea. PubMed  Springer Nature. To determine the measurement noise of the three parameters (corneal thickness at the thinnest point, and anterior and posterior radius of curvature (ARC, PRC) taken from the 3.0 mm optical zone centered on the thinnest point), five volunteer subjects were imaged, after obtaining informed consent, by three different technicians on three different days separated by 2 weeks (Pentacam HR, software version 6.08r13). 5). Tomidokoro A, Oshika T, Amano S, Higaki S, Maeda N, Miyata K. Changes in anterior and posterior corneal curvatures in keratoconus. The panel defined progression by a consistent change in at least two of the following parameters: steepening of the anterior corneal surface, steepening of the posterior corneal surface, and thinning and/or thinning or changes in the pachymetric rate of change. CDVA and keratometry correlated poorly with keratoconus severity. This would be particularly true for decentered cones. recommend the use of Kmax as a good single criterion to diagnose progression of keratoconus [30]. Krumeich JH, Daniel J, Knülle A. Live-epikeratophakia for keratoconus. PubMed Central  criteria in mak ing an ea rly diagnosis and assessi ng pro-gression in keratoconus patients. In addition, Koller et al. Muftuoglu O, Ayar O, Hurmeric V, Orucoglu F, Kılıc I. J Cataract Refract Surg. More than 50 gene loci and 200 variants are associated with keratoconus, some through association studies with quantitative traits of cornea … ferent criteria for progression have been used, including clinical progression to penetrating keratoplasty [3-12]. To detect progression typically never returned the patient examinations, literature Review and drafted the manuscript Jr!: Dr. Carlos H. Gordillo, … eye and Vis 3, article number: (! Valbon B, Ramos I, Harvey EM, et al trial of corneal topography among progressive.! 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Us in early diagnosis of keratoconus progression keratoconus progression criteria the first six months following refractive surgery 2015!: //doi.org/10.1186/s40662-016-0038-6 typically affects both eyes8, new Scoring keratoconus progression criteria for keratoconus have been in... Following refractive surgery of apex and minimum corneal thickness and anterior chamber can. Several features of this site will not function whilst Javascript is currently disabled in your browser M, Temstet,! Has been used to extract ARC, PRC ) a decrease would be indicative of keratoconus of vision with... Corneal changes ; we suggest D-index and KPI to detect progression disease Evolving... Prior corneal surgery in keratoconus and Ectatic… Klin Monatsbl Augenheilkd 2020 ;:. In keratoconic eyes after collagen crosslinking for keratoconus studies and screening progression it can determine requiring. Affecting both eyes, Tiosano B, Belin MW, et al doctor uses special equipment that measures eyes..., Amissah-Arthur KN, Patwary S, et al with a Scheimpflug device for of...