Revisiting Pentacam Parameters in the Diagnosis of Subclinical and Mild Keratoconus Based on Different Grading System Definitions

Autor: Toprak İ; Pamukkale University Faculty of Medicine, Department of Ophthalmology, Denizli, Türkiye, Martin Ç; Pamukkale University Faculty of Medicine, Department of Ophthalmology, Denizli, Türkiye, Güneş CE; Pamukkale University Faculty of Medicine, Department of Ophthalmology, Denizli, Türkiye, Alio J; Department of Research and Development, VISSUM, Alicante, Spain; Cornea, Cataract and Refractive Surgery Department, VISSUM, Alicante, Spain; Division of Ophthalmology, Department of Pathology and Surgery, Faculty of Medicine, Miguel Hernández University, Alicante, Spain
Jazyk: angličtina
Zdroj: Turkish journal of ophthalmology [Turk J Ophthalmol] 2023 Dec 21; Vol. 53 (6), pp. 324-335. Date of Electronic Publication: 2023 Nov 27.
DOI: 10.4274/tjo.galenos.2023.68188
Abstrakt: Objectives: To retest the performance of Pentacam parameters in the detection of eyes with subclinical keratoconus (KC) and mild KC based on different definitions from the Amsler-Krumeich (AK), Collaborative Longitudinal Evaluation of Keratoconus (CLEK), and ABCD systems.
Materials and Methods: This cross-sectional university-based study comprised 24 eyes with subclinical KC, 144 eyes with mild KC (based on AK in 101 eyes, CLEK in 28 eyes, and ABCD in 15 eyes), and 70 controls. Diagnostic ability of the thinnest point (TP) pachymetry, KISA% index, inferior-superior asymmetry, corneal aberrations, Pentacam indices, front/back elevations, pachymetric progression index, Ambrósio-Relational Thickness (ARTmax), and Belin/Ambrósio Enhanced Ectasia Display scores (Df, Db, Dp, Dt, Da, and D-final) were evaluated.
Results: ARTmax (83.3% sensitivity/74.3% specificity) had the highest ability in distinguishing subclinical KC from normal, followed by TP pachymetry, Dt, and Da. D-final showed excellent sensitivity/specificity in mild KC diagnosis based on AK (98%/100%) and CLEK (97.4%/100%) descriptions. In the mild KC-ABCD group, index of vertical asymmetry accurately detected all eyes with mild KC and 97.1% of the controls.
Conclusion: This study points out the gray zone in the detection of eyes with subclinical and mild KC due to overlapping terminology and grading criteria. Pentacam parameters seem to have modest capability in subclinical KC detection, indicating the necessity for additional diagnostic modalities. However, eyes with mild KC can be diagnosed with high accuracy using Pentacam parameters, although the strongest parameters may vary according to the definition of “mild KC.” Nevertheless, uniform and definitive criteria for subclinical and clinical KC classification are required for a diagnostic and therapeutic consensus in KC.
Competing Interests: Conflict of Interest: The authors declare no financial or proprietary interest in any product or company associated with any device, instrument or drug mentioned in this article.
(©Copyright 2023 by the Turkish Ophthalmological Association / Turkish Journal of Ophthalmology published by Galenos Publishing House.)
Databáze: MEDLINE
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