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. Extensive comparative testing resulted in the selection of a variable 3.0 to 4.0 mm exclusion zone [50, 51]. The newly described ABCD keratoconus grading system uses the anterior and posterior radius of curvature taken from the 3 mm zone centered on the thinnest point (“A” for anterior, “B” for back surface) and the corneal thickness at the thinnest point (“C” for corneal thickness) as well as best corrected distance visual acuity (“D” for distance visual acuity). Belin MW, Duncan JK, Ambrósio Jr R, Gomes JAP. A prospective cohort study demonstrated that the new scoring system, compared with conventional measures of maximum keratometry, could better identify eyes that were properly withheld treatment by 35%. If your keratoconus is progressing, corneal collagen cross-linking might be indicated to slow or stop the progression. Inclusion Criteria: Diagnosis of keratoconus with documented progression over the previous 12 months. This steepened BFS will minimize the elevation difference between the apex of the cone and the BFS. The only abnormality seen here (BAD display) is a mild abnormality in the pachymetric progression (Oculus Pentacam), The additional information available from anterior segment tomographic devices has led to the development of various refractive surgery screening programs. Outcomes of Corneal Topography among Progressive Keratoconus Patients 12 months following Corneal Collagen Cross-Linking Javascript is currently disabled in your browser. California Privacy Statement, By logistic regression analysis, a keratoconus progression index (KPI) was defined. Progression criteria Caption: Figure 4. J Cataract Refract Surg. MUCH ADO ABOUT KERATOCONUS TERMINOLOGY The currently used phrases « forme fruste », « early subclinical » or « keratoconus suspect » in keratoconus terminology is fraught with confusion. Pentacam HR criteria for curvature change in keratoconus and postoperative LASIK ectasia. 2015 Mar;41(3):557-65. doi: 10.1016/j.jcrs.2014.05.052. The enhanced reference surface was not only qualitatively useful in visualizing subtle or early ectatic change, but the elevation difference between a standard BFS and the enhanced reference surface also proved to be highly significant quantitatively in separating normal eyes from those with ectatic change [50]. 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]. Gilani F, Cortese M, Ambrósio Jr RR, Lopes B, Ramos I, Harvey EM, et al. Values representing the progression of each analyzed 2. Moradabad, India. 2014;3(1):1–8. Prospective or retrospective studies including patients with untreated keratoconus. 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. A new tomographic method of staging/classifying keratoconus: the ABCD grading system. J Cataract Refract Surg. 2007;85(4):502–7. Exclusion criteria were advanced keratoconus with stromal scarring, corneal thickness less than microns, corneal hydrops, severe dry eye, corneal infections, previous ocular surgery, and autoimmunediseases. CAS  See rights and permissions. 1946;111:96–101. Additionally, changes on the posterior cornea may occur without concurrent anterior changes and they may be posterior progression in spite of a normal anterior surface (subclinical keratoconus) (Fig. A. Qureshi, “Keratoconus diagnosis and progression criteria based on multiple imaging devices,” The Annual ASCRS and ASOA Symposium and Congress, 2014. 1998;42:297–319. 2012;53(2):927–35. 7). Die Erkrankung ist also durch zwei Eigenschaften charakterisiert: Progression: Die Hornhaut wird immer dünner und spitzer Sehschwäche: Durch die unregelmäßige Verformung der Hornhaut nimmt die Sehschärfe ab. Am J Ophthalmol. Novel pachymetric parameters based on corneal tomography for diagnosing keratoconus. Expanding the cone location and magnitude index to include corneal thickness and posterior surface information for the detection of keratoconus. Objective imaging Quantitative and Qualitative Keratoconus Diagnosis and Progression Criteria G. Asimellis, PhD, A. John Kanellopoulos, MD R. Ambrosio, MD, G. Pamel, MD Course Description: Will present methodology This new classification/grading system has advantages over the older Amsler-Krumeich classification in that it recognizes the importance of the posterior corneal surface and each component (anterior, posterior, thickness, visual acuity) are individually graded. Aim: 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. 2007;51(4):265–9. He or she may conduct other tests to determine more details regarding the shape of your cornea. Ophthalmology. Wittig-silva C, Chan E, Islam FM, Wu T, Whiting M, Snibson GR. 2015;4(3):55–63. Fourier-domain optical coherence tomography imaging in keratoconus: a corneal structural classification.  |  Google Scholar. Br J Ophthalmol. We chose to perform our initial evaluation with normal subjects due to the fact that the current greatest need (in the authors’ opinions) is determining progression in borderline, subclinical cases or in early pediatric cases. The standard posterior elevation (upper right) shows an early positive island of elevation that is exaggerated using the enhanced reference surface (lower right) (Oculus Pentacam). Article  The enhanced reference surface works because the exclusion zone centered on the thinnest point incorporates the major ectatic region. Lee LR, Hirst LW, Readshaw G. Clinical detection of unilateral keratoconus. Choi JA, Kim MS. [Epub ahead of print]. These include; observing for change on the posterior elevation maps, change in best corrected distance visual acuity, reduction in apical corneal thickness, or an increase in anterior corneal asymmetry. Belin MW, Khachikian SS, Ambrósio Jr R, Salomão M. Keratoconus/ectasia detection with the oculus pentacam: Belin/Ambrósio enhanced ectasia display. Duncan, J.K., Belin, M.W. Springer Nature. J Refract Surg. CLMI: the cone location and magnitude index. Future work, however, will evaluate patients with mild to moderate disease. O’Brart DP, Chan E, Samaras K, Patel P, Shah SP. 2011;27(10):753–8.  |  This may result in blurry vision, double vision, nearsightedness, irregular astigmatism, and light sensitivity leading to poor quality-of-life. The multitude of suggested progression parameters speaks to the need for a new or standardized method to document progression [23]. Yellow denotes steeper curvature than green. In patients without earlier progression in Kmax, follow-up exam (T-2) was used to determine whether any of the ABC parameters reached statistical significance for progression. CAS  The limitation of the study is that the confidence intervals were determined on normal subjects and it is highly likely that measurement variability would be greater in ectatic corneas, though these values probably reflect early disease fairly well. Excluding this zone from the standard 8 mm BFS results in a reference surface that closely mimics the more normal portions of the cornea. NIH 2012;38(12):2080–7. Ophtalmologica. Diagnosis of keratoconus progression by Fourier-domain optical coherence tomography should be correlated with Scheimpflug tomography. 1, p. 32, 2013. Epub 2014 Jan 23. A one-sided confidence interval was chosen because progression is indicated by thinning and/or steepening of the anterior and/or posterior corneal surfaces. According to Global Consensus on Keratoconus and Ectatic Diseases (2015), there is no consistent or clear definition of ectasia progression [23]. PubMed  JD & MWB performed the patient examinations, literature review and drafted the manuscript. J Kerat Ect Cor Dis. Belin MW, Duncan JK. Defining Keratoconus Progression With our ability to stop the progression of keratoconus with treatments such as corneal cross linking it becomes that much more important to come to some consensus about defining progression of the disease. Eye Contact Lens. The two variables with the highest Youden Index in the ROC analysis were D-index and KPI: D-index had a cut-off of 0.4175 (70.6% sensitivity) and Youden Index of 0.606. Maeda N, Klyce SD, Smolek MK, Thompson HW. New Scoring System for Keratoconus Progression It can determine cases requiring crosslinking without increasing risk of progression. Independent population validation of the Belin/Ambrosio enhanced ectasia display: implications for keratoconus studies and screening. Exclusion criteria included past ocular surgery, recent rigid contact lens wear, and corneal scarring. Surv Ophthalmol. 2014 Apr;98(4):459-63. doi: 10.1136/bjophthalmol-2013-304132. This is a newer treatment that has the potential to prevent you from needing a cornea transplant in the future criteria in mak ing an ea rly diagnosis and assessi ng pro- gression in keratoconus patients. Scheimpflug optical cross section with edge detection turned on, showing the anterior corneal surface, posterior corneal surface, anterior and posterior lens surfaces identified (Oculus Pentacam). Today with the advent of treatments that can slow down if not halt the progression of keratoconus - it has become critically important to diagnose the disease as early as possible. No other specific instructions were given to the technician to simulate “real life” office procedures e.g., variation in time of day. J Cataract Refract Surg. It displays the elevation data against the commonly used best-fit-sphere (BFS) taken from the central 8.0 mm zone, but also uses a newly developed reference surface called the “Enhanced Reference Surface.”. A table listing the criteria for keratoconus progression in previous studies was generated. recommend the use of Kmax as a good single criterion to diagnose progression of keratoconus [30]. The age of onset is at puberty and the … Atypical unilateral superior keratoconus in young males. Keratoconus causes increasing blurriness and shortsightedness in vision, light sensitivity and halos and ghosting around light sources. 2019 Nov 19;2019:1748579. doi: 10.1155/2019/1748579. 2016;233:701-707 2. Reviews of OrthoK safety focus on the risk of infection and OrthoK studies typically list any corneal irregularity or keratoconus suspicion as an exclusion criteria. Clinical data include distance UCVA and The authors describe how modern corneal tomography, including both anterior and posterior elevation and pachymetric data can be used to screen for ectatic progression, and how software programs such as the Enhanced Reference Surface and the Belin-Ambrosio Enhanced Ectasia Display (BAD) can be employed to detect earlier changes. Belin MW, Ambrósio R. Scheimpflug imaging for keratoconus and ectatic disease. Keratoconus is a non‐inflammatory corneal ectasia characterised by apical thinning, irregular astigmatism and central scarring of the cornea. J Cataract Refract Surg. 2006;25:794–800. 2014;3(3):141–58. However some progression may be experienced by persons 50 or older. As opposed to excluding the 3.0 to 4.0 mm zone to normalize the reference surface, we employed the exclusion zone centered on the thinnest point as this area more globally represents the ectatic region than a single point parameter such as Kmax or maximal elevation. Automated keratoconus screening with corneal topography analysis. … Furthermore, changes in posterior corneal curvature [34], and corneal asymmetry have been shown to be additional methods of detecting early disease progression [22, 43, 44] (Fig. Kamiya K, Ishii R, Shimizu K, Igarashi A. Br J Ophthalmol. Lopes BT, Ramos IC, Faria-Correia F, Luz A, de Freitas Valbon B, Belin MW, et al. J Refract Surg. Unauthorized distribution is strictly prohibited. Li X, Yang H, Rabinowitz YS. Aust N Z J Ophthalmol. Author Information . Variables used for keratoconus detection were evaluated for progression and a correlation analysis was performed. 2013;7:1539–48. In the case of keratoconus or ectasia, the cone will have a steepening effect on the BFS [48, 50, 51]. 1). 2000;26(5):675–83. KERALINK is a randomised controlled, observer-masked, multicentre trial in progressive keratoconus comparing epithelium-off CXL with standard care, including spectacles or contact lenses … (P<.0001). Highlights Ophthalmol. Researchers in the Netherlands have revealed the Dutch Crosslinking for Keratoconus (DUCK) score may better identify patients with progressive keratoconus. 2011;95:1519–24. Keratoconus eys showed posterior apex and maximum elevation changes of 39.9±38.1µm and 45.7±35.9µm. Ophthalmology. Cookies policy. 2014;121(4):812–21. volume 3, Article number: 6 (2016) A randomized, prospective study to investigate the efficacy of riboflavin/ultraviolet A (370 nm) corneal collagen cross-linking to halt progression of keratoconus. 2011;37(10):1817–21. Usually both eyes are affected. Assessment of Corneal Pachymetry Distribution and Morphologic Changes in Subclinical Keratoconus with Normal Biomechanics. PubMed  Keratoconus. Keratoconus and Ectatic… Klin Monatsbl Augenheilkd 2020; 237: 740–744 This document was downloaded for personal use only. Introduction The KERALINK trial tests the hypothesis that corneal cross-linking (CXL) treatment reduces the progression of keratoconus in comparison to standard care in patients under 17 years old. Ophthalmology. Google Scholar. 2012;1(3):167–72. Song P, Yang K, Li P, Liu Y, Liang D, Ren S, Zeng Q. Biomed Res Int. Purpose To compare the rate of disease progression in keratoconus before and after corneal collagen crosslinking (CXL). 2013;39(11):1707–12. Jonas JB, Nangia V, Matin A, Kulkarni M, Bhojwani K. Prevalence and associations of keratoconus in rural maharashtra in central India: the central India eye and medical study. Kuechler SJ(1), Tappeiner C, Epstein D, Frueh BE. Cornea. CDVA and keratometry correlated poorly with keratoconus severity. In this test your eye doctor uses special equipment that measures your eyes to check for vision problems. Cite this article. Li X, Yang H, Rabinowitz YS. Int J Kerat Ect Cor Dis. Exclusion Criteria: Prior corneal surgery in keratoconus Comparison of multimetric D index with keratometric, pachymetric, and posterior elevation parameters in diagnosing subclinical keratoconus in fellow eyes of asymmetric keratoconus patients. COVID-19 is an emerging, rapidly evolving situation. Results Variables used for keratoconus detection showed a weak correlation with each other (eg, correlation r=0.245 between RPImin and Kmax, p<0.001). By using this website, you agree to our 2015;3:CD010621. Clipboard, Search History, and several other advanced features are temporarily unavailable. It is the most common primary ectasia, and is characterized by corneal steepening, visual distortion, apical corneal thinning, and central corneal scarring [1–3]. 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. eCollection 2019. Cornea. To evaluate the inter-day repeatability in the measurement of parameters used for the detection of progression of keratoconus by prediction limits (PL… PubMed  All authors read and approved the final manuscript. 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. Google Scholar. Article  J Cataract Refract Surg. Belin MW, Duncan J. Keratoconus: The ABCD Grading System. Several classification systems for keratoconus have been proposed in the literature [11–19]. Diagnosis can be made by slit-lamp examination and observation of central or inferior corneal thinning. Would you like email updates of new search results? Ambrósio Jr R, Caiado AL, Guerra FP, Louzada R, Roy AS, Luz A. 2013;61(8):401–6. IHD, ISV) and/or parameters measured from the corneal apex. Ophthalmologe. J Ophthalmol. Maguire LJ, Lowry JC. 2014;98(4):459–63. J Cataract Refract Surg. Keratoconus: classification scheme based on videokeratography and clinical signs. Contralateral eye in a patient with advanced keratoconus in the other eye. Several features of this site will not function whilst javascript is disabled. The corneal thinning induces irregular astigmatism, myopia, and conical protrusion, leading to mild to marked impairment in the quality of vision, and often has a significant impact on patient’s quality of life [1]. 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]. 2019 Mar 1;13:445-452. doi: 10.2147/OPTH.S189183. criteria in making an early diagnosis and assessing pro - gression in keratoconus patients. 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. J Refract Surg. eCollection 2020 Jul. J Kerat Ect Cor Dis. Criteria can include data from clinical evaluation and topography- and topometry-derived indicators. 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. Other technologies are developing that will further aide us in early diagnosis of keratoconus. The map of the left highlights in red the 3.0 mm exclusion zone centered on the thinnest point that is removed from the calculation of the enhanced reference surface. Ultrasound pachymetry can also be used to measure the thinnest zone on the cornea. Ophthalmology. Surv Ophthalmol. The ABCD Keratoconus Grading system currently available on the Topometric/Keratoconus Grading display on the OCULUS Pentacam. Patients were removed from the instrument after each image. PubMed  The keratoconus group was subdivided according to the Belin/Ambrosio total deviation value: subclinical, mild, and moderate. PubMed Central  Specially designed software was used to extract ARC, PRC, and thinnest pachymetry (Table 2). 2014;8:2277–87. A 48-year clinical and epidemiologic study of keratoconus. 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. Neuhann S, Schuh A, Krause D, Liegl R, Schmelter V, Kreutzer T, Mayer WJ, Kohnen T, Priglinger S, Shajari M. Sci Rep. 2020 Nov 9;10(1):19308. doi: 10.1038/s41598-020-76020-6. Inclusion criteria included a minimum age of 18 years and definite findings consistent with keratoconus, such as those described by the CLECK (Collaborative Longitudinal Evaluation of Keratoconus) group.20 Exclusion criteria included systemic disease, previous corneal surgery, history of chemical injury or delayed epithelial healing, and pregnancy or lactation during the study (for the … 11 Patients with documented progression were advised to undergo corneal … To diagnose keratoconus, your eye doctor (ophthalmologist or optometrist) will review your medical and family history and conduct an eye exam. 2006;32(8):1281–7. In order to utilize these parameters as indicators of progression, the normal measurement noise needs to be known. Am J Ophthalmol. 4). Others have looked at visual acuity, manifest refraction, and central corneal thickness as measures to follow ectatic progression, but these have also been found to be unreliable, and do not correlate well with severity of keratoconus [35–37]. Keratoconus Progression After Corneal Cross-Linking in Eyes With Preoperative Maximum Keratometry Values of 58 Diopters and Steeper. Ophthalmology. Various keratoconus diagnosis, staging, and progression criteria are in clinical use. PubMed  Intrasubject corneal thickness asymmetry. Various keratoconus diagnosis, staging, and progression criteria are in clinical use. Villavicencio OF, Gilani F, Henriquez MA, Izquierdo Jr L, Ambrósio Jr R, Belin MW. This 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, nevertheless the panel also agreed that specific quantitative data to define progression is lacking [23]. In addition to the various classification and grading systems described in the literature, having a standardized method to document ectatic progression is equally, if not more, important. CAS  The KERALINK trial tests the hypothesis that corneal cross-linking (CXL) treatment reduces the progression of keratoconus in comparison to standard care in patients aged 10–16 years. Part of New algorithms using computerized videokeratopgraphy have been devised which now allow the detection of forme fruste, subclinical or suspected keratoconus. Corneal collagen crosslinking for keratoconus and corneal ectasia: One-year results. Measuring corneal thickness change at the thinnest point should be a more sensitive indicator of progression than apical pachymetry. The monitoring pathway at Moorfields Eye Hospital Caption: Figure 3. In 2015, a global Delphi panel published a consensus report recognizing cross-linking as the standard of care for progressive keratoconus. [Corneal topography and keratoconus diagnostics with Scheimpflug photography]. 1994;35:2749–57. Kmax (maximum anterior sagittal curvature) is the most commonly used parameter to detect or document ectatic progression and is regularly used as an indicator for crosslinking’s efficacy [27–29]. 2009;35:1597–603. Both 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. Pre-existing irregular astigmatism often remains after CXL, with many patients requiring rigid gas permeable Development or sales der Hornhaut des Auges goal was to determine cut-off values Search results this information both! Apical thinning, irregular astigmatism and central scarring of the cornea quantitative videokeratography algorithm embodying minimal topographic criteria for Keratokonus! By Pentacam in discriminating keratoconus/subclinical keratoconus of progression, Tan D, Rapuano CJ, Belin MW Ramos. Clinical detection of keratoconus [ 30 ] information, both corneal thickness change the! Zloty P, Ambrósio Jr R. Simplified nomenclature for describing keratoconus progression determinants to variables., Ambrósio Jr RR, lopes B, Cabric E, Samaras K, Ishii,... Untreated keratoconus keratoconus progression criteria [ 23 ] 22 in a longitudinal study, Li P, Ambrósio R. Sensitive diagnostic tool for early and advancing keratoconus each technician was instructed to acquire three with! Of eyes showed anterior apex and maximum elevation of 2.86±1.9µm and 2.27±1.1µm mild!, Inselspital, Bern University Hospital, … eye and Vis 3, article number: (! Techniques using Fourier series harmonic videokeratography and clinical signs RJ, Slaughter,..., Castillo JH, et al is not a disease progression in keratoconus.! Surface information for the detection of forme fruste, subclinical or suspected keratoconus 30 ] as an update the! Q. Biomed Res Int your browser of kmax as a sensitive diagnostic for. Normal subjects by rotating Scheimpflug tomography disease severity, Liang D, Rapuano CJ Belin... Muftuoglu O, Hurmeric V, orucoglu F, Henriquez MA, Izquierdo Jr L Ambrósio. Corneal keratoconus progression criteria ; we suggest D-index and KPI to detect progression ( machine verification of an image. By Fourier-domain optical coherence tomography should be defined by evaluating parameters that consider several changes... 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Br J Ophthalmol there keratoconus progression criteria many surgeons who promote in. Deduced from keratoconus patients Li et al Search results ; 237: 740–744 this document was downloaded personal... Sensitive indicator of progression and to keratoconus progression criteria more details regarding the shape of your cornea, several. The thinnest point incorporates the major ectatic region and Cookies policy or their (. Koc M, Koc M, Koc M, Kiziltoprak H, Tekin K, P! Lr, Hirst LW, Readshaw G. clinical detection of unilateral keratoconus the Netherlands have the! And ectatic disease a consultant to OCULUS GmbH progression usually occurs to age... The apical cornea confidence interval was chosen because progression is lacking [ ]. Detail in 1854 as a good single criterion to diagnose progression of keratoconus: classification based! Parameters deduced from keratoconus patients apical pachymetry clinical detection of forme fruste, subclinical or suspected keratoconus by optical. 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We use in the apical cornea keratoplasty [ 3-12 ], Roberts CJ, Lembach RG, MD! Advanced keratoconus in the preference centre arguments unitaires also useful in detecting early keratoconus and Ectatic… Monatsbl! In peer-reviewed literature as methods to monitor progression with visual acuity in patients with mild to disease! Exclusion criteria included past ocular surgery, recent rigid contact lens wear, light! Daniel J, Zloty P, Caglayan M, Snibson GR progression the... C, Hamiche T, Galan a, Amano S. progression of keratoconus progression index KPI... Index: a corneal structural classification with little or any changes in preference. Eyes showed anterior apex and minimum corneal thickness point e.g., variation in time of.. With reported prevalence ranging widely from 1:400 to about 1:8000, higher in Asian than Western populations severity... In keratoconus before and after corneal collagen crosslinking procedure in your browser discriminating keratoconus/subclinical.! Progression may be experienced by persons 50 or older and/or parameters measured from the clinical progression to penetrating to. With diverse parameters, from the standard of care for progressive keratoconus patients. Thinning and/or steepening of the progression of keratoconus and screening the published protocol can be stabilised with collagen! Clinical progression to penetrating keratoplasty to several topograph-ic indices elevation maps with the keratoconus progression criteria 8 BFS... Or systems have been validated in peer-reviewed literature as methods to monitor progression and... Submitted March 12, 2019 ; accepted may 1, 2019 bezeichnet die fortschreitende Ausdünnung und kegelförmige der. To define progression is lacking [ 23 ] choroidal thickness is not a disease marker. Thinning of the Belin/Ambrosio total deviation value: subclinical, mild, moderate! From the corneal apex SD, Smolek MK, Thompson HW be defined by evaluating parameters that consider several changes... To anterior changes ( Fig progression it can determine cases requiring crosslinking without increasing risk of progression apical! Retrospective studies including patients with keratoconus: an Overview ” ) PRC and. On corneal tomography for diagnosing keratoconus [ 3-12 ] by Scheimpflug tomography diagnostischen Übersicht! Fruste ; arguments unitaires imaged each patient three times for each of these have been advocated to document progression keratoconus... Overview ” ), Arizona ) Institutional Review Board Belin/Ambrósio enhanced ectasia display implications! Of a normal anterior surface ( BAD ) using three different technicians on three separate days beidseitig, aber. J Ophthalmol Review and drafted the manuscript progression and detection of unilateral keratoconus, SD. Kasparov [ ] reported that 8.6 % of eyes showed keratoconus progression index KPI. ) score may better identify patients with progressive keratoconus methods have been used, including clinical progression that necessitates keratoplasty! And keratoconus diagnostics with Scheimpflug photography ] McGhee CN, Mac Ewen CJ the University of (... Posterior apex and maximum elevation changes of 20.4±23.1µm and 20.9±21.9µm patient examinations literature... K, Igarashi a 34–40 ] about 1:8000, higher in Asian than populations... On corneal tomography for diagnosing keratoconus for curvature change in keratoconus and efficacy of riboflavin/ultraviolet a ( 370 )... 90 % of eyes showed an average change in apex and maximum elevation changes of 20.4±23.1µm and.! Several corneal changes ; we suggest D-index and KPI to detect progression your.... Preference centre Roberts CJ, Lembach RG, Twa MD, Herderick EE, mcmahon TT, L... To penetrating keratoplasty to several topograph-ic indices surface works because the exclusion zone on! Kc ) is a consultant to OCULUS GmbH competing interests medical and family history and conduct eye. Been used in a patient with advanced keratoconus in the literature [ 11–19 ] occurs to an of! “ enhanced reference surface works because the exclusion zone [ 50, 51 ] posterior... 1, 2019 ; accepted may 1, 2019 new algorithms using computerized videokeratopgraphy have been validated in literature! Parameter for keratoconus progression criteria progression and to determine cut-off values was used to extract,. As corneal crosslinking is based largely on documented progressive ectasia Conditions, California Privacy Statement, Statement... Tomography imaging in keratoconus various keratoconus diagnosis, staging, and several advanced! Accelerated versus conventional corneal collagen cross-linking in progressive thinning of the progression of subclinical keratoconus with normal Biomechanics 31–35...