Revisiting keratoconus diagnosis and progression classification based on evaluation of corneal asymmetry indices, derived from Scheimpflug imaging in keratoconic and suspect cases

Anastasios John Kanellopoulos,1,2 George Asimellis1 1Laservision.gr Eye Institute, Athens, Greece; 2New York University School of Medicine, New York, NY, USA Purpose: To survey the standard keratoconus grading scale (Pentacam®-derived Amsler–Krumeich stages) compared to corneal irr...

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Autores principales:	Kanellopoulos AJ, Asimellis G
Formato:	article
Lenguaje:	EN
Publicado:	Dove Medical Press 2013
Materias:	Ophthalmology RE1-994
Acceso en línea:	https://doaj.org/article/a15389e31c5b420aa8654a93107088b0
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spelling	oai:doaj.org-article:a15389e31c5b420aa8654a93107088b02021-12-02T01:47:53ZRevisiting keratoconus diagnosis and progression classification based on evaluation of corneal asymmetry indices, derived from Scheimpflug imaging in keratoconic and suspect cases1177-54671177-5483https://doaj.org/article/a15389e31c5b420aa8654a93107088b02013-07-01T00:00:00Zhttp://www.dovepress.com/revisiting-keratoconus-diagnosis-and-progression-classification-based--a13805https://doaj.org/toc/1177-5467https://doaj.org/toc/1177-5483Anastasios John Kanellopoulos,1,2 George Asimellis1 1Laservision.gr Eye Institute, Athens, Greece; 2New York University School of Medicine, New York, NY, USA Purpose: To survey the standard keratoconus grading scale (Pentacam®-derived Amsler–Krumeich stages) compared to corneal irregularity indices and best spectacle-corrected distance visual acuity (CDVA). Patients and methods: Two-hundred and twelve keratoconus cases were evaluated for keratoconus grading, anterior surface irregularity indices (measured by Pentacam imaging), and subjective refraction (measured by CDVA). The correlations between CDVA, keratometry, and the Scheimpflug keratoconus grading and the seven anterior surface Pentacam-derived topometric indices – index of surface variance, index of vertical asymmetry, keratoconus index, central keratoconus index, index of height asymmetry, index of height decentration, and index of minimum radius of curvature – were analyzed using paired two-tailed t-tests, coefficient of determination (r2), and trendline linearity. Results: The average ± standard deviation CDVA (expressed decimally) was 0.626 ± 0.244 for all eyes (range 0.10–1.00). 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). CDVA and keratometry correlated poorly with keratoconus severity. Conclusion: It is reported here for the first time that the index of surface variance and the index of height decentration may be the most sensitive and specific criteria in the diagnosis, progression, and surgical follow-up of keratoconus. The classification proposed herein may present a novel benchmark in clinical work and future studies. Keywords: diagnosis and classification, Pentacam topometric indices, Amsler–Krumeich keratoconus grading, surface variance, vertical asymmetry, keratoconus index, central keratoconus index, height asymmetry, height decentration, minimum radius of curvatureKanellopoulos AJAsimellis GDove Medical PressarticleOphthalmologyRE1-994ENClinical Ophthalmology, Vol 2013, Iss default, Pp 1539-1548 (2013)
institution	DOAJ
collection	DOAJ
language	EN
topic	Ophthalmology RE1-994
spellingShingle	Ophthalmology RE1-994 Kanellopoulos AJ Asimellis G Revisiting keratoconus diagnosis and progression classification based on evaluation of corneal asymmetry indices, derived from Scheimpflug imaging in keratoconic and suspect cases
description	Anastasios John Kanellopoulos,1,2 George Asimellis1 1Laservision.gr Eye Institute, Athens, Greece; 2New York University School of Medicine, New York, NY, USA Purpose: To survey the standard keratoconus grading scale (Pentacam®-derived Amsler–Krumeich stages) compared to corneal irregularity indices and best spectacle-corrected distance visual acuity (CDVA). Patients and methods: Two-hundred and twelve keratoconus cases were evaluated for keratoconus grading, anterior surface irregularity indices (measured by Pentacam imaging), and subjective refraction (measured by CDVA). The correlations between CDVA, keratometry, and the Scheimpflug keratoconus grading and the seven anterior surface Pentacam-derived topometric indices – index of surface variance, index of vertical asymmetry, keratoconus index, central keratoconus index, index of height asymmetry, index of height decentration, and index of minimum radius of curvature – were analyzed using paired two-tailed t-tests, coefficient of determination (r2), and trendline linearity. Results: The average ± standard deviation CDVA (expressed decimally) was 0.626 ± 0.244 for all eyes (range 0.10–1.00). 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). CDVA and keratometry correlated poorly with keratoconus severity. Conclusion: It is reported here for the first time that the index of surface variance and the index of height decentration may be the most sensitive and specific criteria in the diagnosis, progression, and surgical follow-up of keratoconus. The classification proposed herein may present a novel benchmark in clinical work and future studies. Keywords: diagnosis and classification, Pentacam topometric indices, Amsler–Krumeich keratoconus grading, surface variance, vertical asymmetry, keratoconus index, central keratoconus index, height asymmetry, height decentration, minimum radius of curvature
format	article
author	Kanellopoulos AJ Asimellis G
author_facet	Kanellopoulos AJ Asimellis G
author_sort	Kanellopoulos AJ
title	Revisiting keratoconus diagnosis and progression classification based on evaluation of corneal asymmetry indices, derived from Scheimpflug imaging in keratoconic and suspect cases
title_short	Revisiting keratoconus diagnosis and progression classification based on evaluation of corneal asymmetry indices, derived from Scheimpflug imaging in keratoconic and suspect cases
title_full	Revisiting keratoconus diagnosis and progression classification based on evaluation of corneal asymmetry indices, derived from Scheimpflug imaging in keratoconic and suspect cases
title_fullStr	Revisiting keratoconus diagnosis and progression classification based on evaluation of corneal asymmetry indices, derived from Scheimpflug imaging in keratoconic and suspect cases
title_full_unstemmed	Revisiting keratoconus diagnosis and progression classification based on evaluation of corneal asymmetry indices, derived from Scheimpflug imaging in keratoconic and suspect cases
title_sort	revisiting keratoconus diagnosis and progression classification based on evaluation of corneal asymmetry indices, derived from scheimpflug imaging in keratoconic and suspect cases
publisher	Dove Medical Press
publishDate	2013
url	https://doaj.org/article/a15389e31c5b420aa8654a93107088b0
work_keys_str_mv	AT kanellopoulosaj revisitingkeratoconusdiagnosisandprogressionclassificationbasedonevaluationofcornealasymmetryindicesderivedfromscheimpflugimaginginkeratoconicandsuspectcases AT asimellisg revisitingkeratoconusdiagnosisandprogressionclassificationbasedonevaluationofcornealasymmetryindicesderivedfromscheimpflugimaginginkeratoconicandsuspectcases
_version_	1718402911537463296

Revisiting keratoconus diagnosis and progression classification based on evaluation of corneal asymmetry indices, derived from Scheimpflug imaging in keratoconic and suspect cases

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