Topographic changes simulating keratoconus in patients with irregular inferior epithelial thickening documented by anterior segment optical coherence tomography

Mohamad El Wardani,1 Kattayoon Hashemi,1 Konstantinos Aliferis,1 George Kymionis1,2 1Department of Ophthalmology, University of Lausanne, Jules-Gonin Eye Hospital, Foundation Asile des Aveugles, Lausanne, Switzerland; 2Department of Ophthalmology, ‘G. Gennimatas Hospital’, Nation...

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Autores principales:	El Wardani M, Hashemi K, Aliferis K, Kymionis G
Formato:	article
Lenguaje:	EN
Publicado:	Dove Medical Press 2019
Materias:	pseudokeratoconus epithelial hyperplasia pentacam epithelial thickness pachymetry Ophthalmology RE1-994
Acceso en línea:	https://doaj.org/article/d18ad430280c4937b52a0f70b4a501b5
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spelling	oai:doaj.org-article:d18ad430280c4937b52a0f70b4a501b52021-12-02T08:09:23ZTopographic changes simulating keratoconus in patients with irregular inferior epithelial thickening documented by anterior segment optical coherence tomography1177-5483https://doaj.org/article/d18ad430280c4937b52a0f70b4a501b52019-10-01T00:00:00Zhttps://www.dovepress.com/topographic-changes-simulating-keratoconus-in-patients-with-irregular--peer-reviewed-article-OPTHhttps://doaj.org/toc/1177-5483Mohamad El Wardani,1 Kattayoon Hashemi,1 Konstantinos Aliferis,1 George Kymionis1,2 1Department of Ophthalmology, University of Lausanne, Jules-Gonin Eye Hospital, Foundation Asile des Aveugles, Lausanne, Switzerland; 2Department of Ophthalmology, ‘G. Gennimatas Hospital’, National and Kapodistrian University of Athens, Athens, GreeceCorrespondence: Mohamad El WardaniJules Gonin Eye Hospital, Faculty of Biology and Medicine, University of Lausanne, Avenue de France 15, Lausanne 1004, SwitzerlandTel +41 21 626 8226Fax +41 21 626 8246Email elwardani@gmail.comPurpose: To present six patients with keratoconus-like topographic changes due to inferior inhomogenous epithelial thickening, demonstrated by AS-OCT epithelium map.Patients and methods: We present twelve eyes of six patients evaluated in the refractive surgery consultation with Pentacam® HR Scheimpflug rotating camera system, presenting topographical irregularities suggestive of keratoconus. Slit-lamp examination, best-corrected visual acuity, Scheimpflug tomography and anterior segment optical coherence tomography epithelium map (Optovue® ) were conducted and analyzed.Results: The mean age was 42 years and the female:male ratio was 2:1. Mean Kmax was 45±2 D. The mean corneal thickness at apex was 560±33 μm and the mean thickness at the thinnest location was 555±34 μm. All patients had an abnormal index of height decentration (IHD) in at least one eye. In all cases, anterior segment OCT demonstrated relative epithelial thickening over the steep area measured by tomography. The mean thickness of the inferior epithelium over the suspicious area was 60±2 μm, whereas the mean thickness of the superior epithelium was 56±2 μm.Conclusion: Epithelial irregularity, as measured by anterior segment OCT, should be considered as a possible contributing factor in the appearance of suspicious keratoconus-like topographies.Keywords: pseudokeratoconus, epithelial hyperplasia, Pentacam, epithelial thickness, pachymetryEl Wardani MHashemi KAliferis KKymionis GDove Medical Pressarticlepseudokeratoconusepithelial hyperplasiapentacamepithelial thicknesspachymetryOphthalmologyRE1-994ENClinical Ophthalmology, Vol Volume 13, Pp 2103-2110 (2019)
institution	DOAJ
collection	DOAJ
language	EN
topic	pseudokeratoconus epithelial hyperplasia pentacam epithelial thickness pachymetry Ophthalmology RE1-994
spellingShingle	pseudokeratoconus epithelial hyperplasia pentacam epithelial thickness pachymetry Ophthalmology RE1-994 El Wardani M Hashemi K Aliferis K Kymionis G Topographic changes simulating keratoconus in patients with irregular inferior epithelial thickening documented by anterior segment optical coherence tomography
description	Mohamad El Wardani,1 Kattayoon Hashemi,1 Konstantinos Aliferis,1 George Kymionis1,2 1Department of Ophthalmology, University of Lausanne, Jules-Gonin Eye Hospital, Foundation Asile des Aveugles, Lausanne, Switzerland; 2Department of Ophthalmology, ‘G. Gennimatas Hospital’, National and Kapodistrian University of Athens, Athens, GreeceCorrespondence: Mohamad El WardaniJules Gonin Eye Hospital, Faculty of Biology and Medicine, University of Lausanne, Avenue de France 15, Lausanne 1004, SwitzerlandTel +41 21 626 8226Fax +41 21 626 8246Email elwardani@gmail.comPurpose: To present six patients with keratoconus-like topographic changes due to inferior inhomogenous epithelial thickening, demonstrated by AS-OCT epithelium map.Patients and methods: We present twelve eyes of six patients evaluated in the refractive surgery consultation with Pentacam® HR Scheimpflug rotating camera system, presenting topographical irregularities suggestive of keratoconus. Slit-lamp examination, best-corrected visual acuity, Scheimpflug tomography and anterior segment optical coherence tomography epithelium map (Optovue® ) were conducted and analyzed.Results: The mean age was 42 years and the female:male ratio was 2:1. Mean Kmax was 45±2 D. The mean corneal thickness at apex was 560±33 μm and the mean thickness at the thinnest location was 555±34 μm. All patients had an abnormal index of height decentration (IHD) in at least one eye. In all cases, anterior segment OCT demonstrated relative epithelial thickening over the steep area measured by tomography. The mean thickness of the inferior epithelium over the suspicious area was 60±2 μm, whereas the mean thickness of the superior epithelium was 56±2 μm.Conclusion: Epithelial irregularity, as measured by anterior segment OCT, should be considered as a possible contributing factor in the appearance of suspicious keratoconus-like topographies.Keywords: pseudokeratoconus, epithelial hyperplasia, Pentacam, epithelial thickness, pachymetry
format	article
author	El Wardani M Hashemi K Aliferis K Kymionis G
author_facet	El Wardani M Hashemi K Aliferis K Kymionis G
author_sort	El Wardani M
title	Topographic changes simulating keratoconus in patients with irregular inferior epithelial thickening documented by anterior segment optical coherence tomography
title_short	Topographic changes simulating keratoconus in patients with irregular inferior epithelial thickening documented by anterior segment optical coherence tomography
title_full	Topographic changes simulating keratoconus in patients with irregular inferior epithelial thickening documented by anterior segment optical coherence tomography
title_fullStr	Topographic changes simulating keratoconus in patients with irregular inferior epithelial thickening documented by anterior segment optical coherence tomography
title_full_unstemmed	Topographic changes simulating keratoconus in patients with irregular inferior epithelial thickening documented by anterior segment optical coherence tomography
title_sort	topographic changes simulating keratoconus in patients with irregular inferior epithelial thickening documented by anterior segment optical coherence tomography
publisher	Dove Medical Press
publishDate	2019
url	https://doaj.org/article/d18ad430280c4937b52a0f70b4a501b5
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Topographic changes simulating keratoconus in patients with irregular inferior epithelial thickening documented by anterior segment optical coherence tomography

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