Pentacam Scheimpflug tomography findings in topographically normal patients and subclinical keratoconus cases.

Autor: Ruiseñor Vázquez PR; ECOS (Clinical Ocular Studies) Laboratory, Buenos Aires, Argentina; Ophthalmology Division, Hospital de Clínicas José de San Martín, University of Buenos Aires, Buenos Aires, Argentina., Galletti JD; ECOS (Clinical Ocular Studies) Laboratory, Buenos Aires, Argentina; Ophthalmology Division, Hospital de Clínicas José de San Martín, University of Buenos Aires, Buenos Aires, Argentina., Minguez N; ECOS (Clinical Ocular Studies) Laboratory, Buenos Aires, Argentina; Ophthalmology Division, Hospital de Clínicas José de San Martín, University of Buenos Aires, Buenos Aires, Argentina., Delrivo M; ECOS (Clinical Ocular Studies) Laboratory, Buenos Aires, Argentina., Fuentes Bonthoux F; ECOS (Clinical Ocular Studies) Laboratory, Buenos Aires, Argentina., Pförtner T; ECOS (Clinical Ocular Studies) Laboratory, Buenos Aires, Argentina., Galletti JG; ECOS (Clinical Ocular Studies) Laboratory, Buenos Aires, Argentina; Institute of Experimental Medicine, National Academy of Medicine/CONICET, Buenos Aires, Argentina. Electronic address: jeremiasg@gmx.net.
Jazyk: angličtina
Zdroj: American journal of ophthalmology [Am J Ophthalmol] 2014 Jul; Vol. 158 (1), pp. 32-40.e2. Date of Electronic Publication: 2014 Apr 05.
DOI: 10.1016/j.ajo.2014.03.018
Abstrakt: Purpose: To evaluate Pentacam ectasia detection indices in topographically normal patients and in subclinical keratoconus cases.
Design: Prospective, observational case series.
Methods: setting: Institutional. patients: Group 1 comprised 1 eye from 189 patients with unremarkable topography and Groups 2 and 3 included the better and worse eyes, respectively, of 55 keratoconic patients. Group 2 eyes with normal topography (n = 37) were considered subclinical keratoconus cases. observation procedure: Pentacam Scheimpflug tomography. main outcome measures: Eleven Pentacam ectasia detection indices.
Results: All Pentacam ectasia indices significantly differed between Groups 1 and 2 and were correlated with keratoconus grade. Only 99 eyes (52%) in Group 1 had normal values for every index, whereas 7 subclinical keratoconus eyes (19%) showed 2 or fewer abnormal indices. Standardized relational thickness and overall deviation indices had 73% and 89% sensitivity for subclinical keratoconus, respectively. Both average and maximum pachymetric progression indices offered 84% sensitivity while maximum relational thickness index showed 78% sensitivity for subclinical keratoconus. Optimized cutoff values for subclinical keratoconus increased the sensitivity of the standardized and maximum relational thickness indices.
Conclusion: Pentacam Scheimpflug tomography can detect most subclinical keratoconus cases with unremarkable topography, but performance is not as good as reported and varies considerably for each index. The overall deviation, average and maximum pachymetric progression, and maximum relational thickness indices offer the highest sensitivity, which can be improved by using optimized cutoff values. Specificity constitutes an issue for some indices and up to 10% of subclinical keratoconus cases may go undetected by this technology.
(Copyright © 2014 Elsevier Inc. All rights reserved.)
Databáze: MEDLINE
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