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Identifying more reliable parameters for the detection of change during the follow-up of mild to moderate keratoconus patients

McAlinden, Colm
Majo, François
Bergin, Ciara
Published in Eye and Vision. 2017, vol. 4, p. 24
Abstract Background: Reaching a consensus on which parameters are most reliable at detecting progressive keratoconus patients with serial topography imaging is not evident. The aim of the study was to isolate the parameters best positioned to detect keratoconus progression using the Pentacam HR (R) measures based on the respective limits of repeatability and range of measurement. Method: Using the Pentacam HR (R), a tolerance index was calculated on anterior segment parameters in healthy and keratoconic eyes. The tolerance index provides a scale from least to most affected parameters in terms of measurement noise relative to that observed in healthy eyes. Then, based on the "number of increments" from no disease to advanced disease, a relative utility (RU) score was also calculated. RU values close to 1 indicate parameters hest positioned to detect a change in keratoconic eyes. Results: The tolerance index values indicated that 36% of ocular parameters for keratoconic eyes had repeatability limit which were wider than normative limits (worse), but 28% of the ocular parameters were narrower than normative limits (better). Considering only those parameters with a RU greater than 0.95, a small number of parameters were within this range, such as corneal curvature and asphericity indices. Conclusions: This study demonstrates that measurement error in keratoconic eyes is significantly greater than healthy eyes. Indices implemented here provide guidance on the levels of expected precision in keratoconic eyes relative to healthy eyes to aid clinicians in distinguishing real change from noise. Importantly maximal keratometry (Kmax), central corneal thickness (CCT) and thinnest corneal thickness (TCT) were highlighted as problematic indices for the follow-up of keratoconus in terms of repeatability.
Keywords PentacamKeratoconusProgressionRepeatabilityPrecisionCorneal crosslinking
PMID: 29124079
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Article (Published version) (389 Kb) - public document Free access
Research group Ophtalmologie expérimentale (925)
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GUBER, Ivo et al. Identifying more reliable parameters for the detection of change during the follow-up of mild to moderate keratoconus patients. In: Eye and Vision, 2017, vol. 4, p. 24. doi: 10.1186/s40662-017-0089-3 https://archive-ouverte.unige.ch/unige:142392

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Deposited on : 2020-10-01

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