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Performances of Corneal Topography and Tomography in the Diagnosis of Subclinical and Clinical Keratoconus. | LitMetric

AI Article Synopsis

  • The study aimed to determine how effective the Pentacam's topographical and tomographical indices are in diagnosing keratoconus, both clinical and subclinical.
  • Among the groups evaluated (clinical keratoconus, subclinical keratoconus, and healthy controls), significant differences were found in the parameters measured, particularly with 11 out of 28 parameters indicating differences in the subclinical group compared to controls.
  • Key measurements such as I-S and CCT showed exceptional diagnostic accuracy, while other indices like Back Kmax and IVA were highlighted as particularly useful for distinguishing between normal eyes and those with subclinical keratoconus.

Article Abstract

Aim: The purpose of the study was to assess the efficacy of topographical and tomographical indices given by the Pentacam (pachymetric, tomopetric, and aberometric) in clinical and subclinical keratoconus (KCN) diagnosis.

Material And Methods: In this observational analytic retrospective study, patients with abnormal findings in topography and tomography maps but with no signs on clinical examination (subclinical KCN group, sKCN), patients with clinical keratoconus (KCN group), and healthy subjects (Control group) were evaluated.

Results: The KCN group proved significantly different (p < 0.001) values of the investigated parameters than the Control group. Eleven out of 28 investigated parameters proved significantly different in the sKCN group compared to controls ( < 0.001). Two topographic measurements, namely I-S (cut-off = 1.435, a large value indicates the presence of KCN) and CCT (cut-off = 537, a small value indicates the presence of KCN), showed AUCs equal to 1 [0.999 to 1]. Six other Pentacam measurements, including Back maximum keratometry (Back Kmax) proved to be excellent parameters for case-finding and screening. In distinguishing sKCN from normal eyes, Pentacam index of vertical asymmetry (IVA), inferior-superior difference (I-S) value, thinnest point (TP), Belin Ambrosio Enhanced Ectasia Display (BAD_D) and root mean square total (RMS total) performed best.

Conclusions: In distinguishing sKCN from normal eyes, Back Kmax, IVA, I-S, and RMS total values demonstrated higher accuracy and utility. Six indices, namely ISV, IVA, KISA, PRC, RMS-HOA, and Back Kmax demonstrate excellent utility in case-finding and screening for clinical KCN.

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Source
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC9204599PMC
http://dx.doi.org/10.3389/fmed.2022.904604DOI Listing

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