Seyed-Farzad Mohammadi1, Vahid Mohammadzadeh2, Sakineh Kadivar3, Amir-Houshang Beheshtnejad1, Amir Hossein Norooznezhad1, Seyed-Hassan Hashemi1. 1. Eye Research Center, Farabi Eye Hospital, Tehran University of Medical Sciences, Qazvin Square, P.O. Box 1336616351, Tehran, Iran. 2. Eye Research Center, Farabi Eye Hospital, Tehran University of Medical Sciences, Qazvin Square, P.O. Box 1336616351, Tehran, Iran. vmohammadzadeh1365@yahoo.com. 3. Eye Research Center, Amiralmomenin Eye Hospital, Guilan University of Medical Sciences, Rasht, Iran.
Abstract
PURPOSE: The term 'keratoconus (KC) suspect' is used as a blanket term to refer to any deviation of virgin cornea shape toward KC features. We intend to subclassify such topographies in meaningful and informative designations. METHODS: Pentacam corneal topographies of 199 consecutive refractive surgery candidates (398 eyes) are examined. Features of steepness, inferior-superior asymmetry, focal steepening, thinning, and bounded anterior or posterior elevations are observed in the quad map. Scissoring on retinoscopy, loss of best spectacle-corrected visual acuity, and iron ring deposition were looked for. Through iterative observation and refinement of classification criteria-partly taken from the literature-all eyes were designated a specific topographic diagnosis, i.e., circumventing the usage of the expression KC 'suspect'. RESULTS: Topographies of 308, 48, 21, 13, 6, 1, and 1 (collectively 398 eyes) were designated: normal, 'atypical normal,' forme fruste KC, posterior KC, subclinical/mild KC, superior KC, and pseudo-KC, respectively. CONCLUSION: Current imaging modalities of the cornea and our accumulated experience in refractive science allow assignment of distinctive designations for abnormal corneal shapes along the topography spectrum. We devised and used the expressions: normal, atypical normal, forme fruste (arrested-incomplete) KC, posterior KC, subclinical (active latent) KC, superior KC, and pseudo-keratoconus. Identification of 1.5% (mild) KC highlights the importance of screening for ultraviolet cross-linkage candidacy in refractive surgery referrals.
PURPOSE: The term 'keratoconus (KC) suspect' is used as a blanket term to refer to any deviation of virgin cornea shape toward KC features. We intend to subclassify such topographies in meaningful and informative designations. METHODS: Pentacam corneal topographies of 199 consecutive refractive surgery candidates (398 eyes) are examined. Features of steepness, inferior-superior asymmetry, focal steepening, thinning, and bounded anterior or posterior elevations are observed in the quad map. Scissoring on retinoscopy, loss of best spectacle-corrected visual acuity, and iron ring deposition were looked for. Through iterative observation and refinement of classification criteria-partly taken from the literature-all eyes were designated a specific topographic diagnosis, i.e., circumventing the usage of the expression KC 'suspect'. RESULTS: Topographies of 308, 48, 21, 13, 6, 1, and 1 (collectively 398 eyes) were designated: normal, 'atypical normal,' forme fruste KC, posterior KC, subclinical/mild KC, superior KC, and pseudo-KC, respectively. CONCLUSION: Current imaging modalities of the cornea and our accumulated experience in refractive science allow assignment of distinctive designations for abnormal corneal shapes along the topography spectrum. We devised and used the expressions: normal, atypical normal, forme fruste (arrested-incomplete) KC, posterior KC, subclinical (active latent) KC, superior KC, and pseudo-keratoconus. Identification of 1.5% (mild) KC highlights the importance of screening for ultraviolet cross-linkage candidacy in refractive surgery referrals.
Authors: A B Nesburn; S Bahri; J Salz; Y S Rabinowitz; E Maguen; J Hofbauer; M Berlin; J I Macy Journal: J Refract Surg Date: 1995 May-Jun Impact factor: 3.573
Authors: Mahsaw N Motlagh; Majid Moshirfar; Michael S Murri; David F Skanchy; Hamed Momeni-Moghaddam; Yasmyne C Ronquillo; Phillip C Hoopes Journal: Med Hypothesis Discov Innov Ophthalmol Date: 2019