Evaluation of Intereye Corneal Asymmetry in Patients with Keratoconus. A Scheimpflug Imaging Study

Purpose: To assess the correlation between keratoconus severity and intereye asymmetry of pachymetric data and posterior elevation values and to evaluate their combined accuracy in discriminating normal corneas from those with keratoconus. Methods: This study included 97 patients: 65 subjects with bilateral normal corneas (NC) and 32 with keratoconus (KC). Central corneal thickness (CCT), thinnest corneal thickness (ThCT) and posterior elevation (PE) at the thinnest point of the cornea were measured in both eyes using Scheimpflug imaging. Intereye asymmetry and its correlation with keratoconus severity were calculated for each variable. The area under the receiver operating characteristic curve (AUROC) was used to compare predictive accuracy of different variables for keratoconus. Results: In normal eyes, intereye differences were significantly lower compared with the keratoconus eyes (p<0.001, for CCT, ThCT and PE). There was a significant exponential correlation between disease severity and intereye asymmetry of steep keratometry (r(2) = 0.55, p<0.001), CCT (r(2) = 0.39, p<0.001), ThCT (r(2) = 0.48, p<0.001) and PE (r(2) = 0.64, p<0.001). After adjustment for keratoconus severity, asymmetry in thinnest pachymetry proved to be the best parameter to characterize intereye corneal asymmetry in keratoconus. This variable had high accuracy and significantly better discriminating ability (AUROC: 0.99) for KC than posterior elevation (AUROC: 0.96), ThCT (AUROC: 0.94) or CCT (AUROC: 0.92) alone. Conclusions: There is an increased intereye asymmetry in keratometry, pachymetry and posterior corneal elevation values in keratoconic patients compared to subjects with normal corneas. Keratoconus patients with more severe disease are also more asymmetric in their disease status which should be taken into account during clinical care

Comparison of corneal morphologic parameters and high order aberrations in keratoconus and normal eyes

The aim of this study is evaluating the influence of corneal geometry in the optical system’s aberrations, and its usefulness as diagnostic criterion for keratoconus.159 normal eyes (normal group, mean age 37.8 ± 11.6 years) and 292 eyes with the diagnosis of keratoconus (keratoconus group, mean age 42.2 ± 17.6 years) were included in this study. All eyes received a comprehensive ophthalmologic examination. A virtual 3D model of each eye was made using CAD software and different anatomical parameters related with surface and volume were measured. Statistically significant differences were found for all anatomical parameters (all p < 0.001). AUROC analysis showed that all parameters reached values above 0.7, with the exception of the total corneal surface area (TCSAA-S). In conclusion, the methodology explained in this research, that bases in anatomical parameters obtained from a virtual corneal model, allow to analyze the diagnostic value of corneal geometry correlation with optical aberrations in keratoconus pathology.This publication has been carried out in the framework of the Thematic Network for Co-Operative Research in Health (RETICS), reference number RD16/0008/0012, financed by the Carlos III Health Institute–General Subdirection of Networks and Cooperative Investigation Centers (R&D&I National Plan 2013–2016) and the European Regional Development Fund (FEDER)

Detection of subclinical keratoconus using biometric parameters

The validation of innovative methodologies for diagnosing keratoconus in its earliest stages is of major interest in ophthalmology. So far, subclinical keratoconus diagnosis has been made by combining several clinical criteria that allowed the definition of indices and decision trees, which proved to be valuable diagnostic tools. However, further improvements need to be made in order to reduce the risk of ectasia in patients who undergo corneal refractive surgery. The purpose of this work is to report a new subclinical keratoconus detection method based in the analysis of certain biometric parameters extracted from a custom 3D corneal model. This retrospective study includes two groups: the first composed of 67 patients with healthy eyes and normal vision, and the second composed of 24 patients with subclinical keratoconus and normal vision as well. The proposed detection method generates a 3D custom corneal model using computer-aided graphic design (CAGD) tools and corneal surfaces’ data provided by a corneal tomographer. Defined bio-geometric parameters are then derived from the model, and statistically analysed to detect any minimal corneal deformation. The metric which showed the highest area under the receiver-operator curve (ROC) was the posterior apex deviation. This new method detected differences between healthy and sub-clinical keratoconus corneas by using abnormal corneal topography and normal spectacle corrected vision, enabling an integrated tool that facilitates an easier diagnosis and follow-up of keratoconus.This publication has been carried out in the framework of the Thematic Network for Co-Operative Research in Health (RETICS) reference number RD16/0008/0012 financed by the Carlos III Health Institute-General Subdirection of Networks and Cooperative Investigation Centers (R&D&I National Plan 2013–2016) and the European Regional Development Fund (FEDER)

Relação dos saltos vertical, horizontal e sêxtuplo com a agilidade e velocidade em crianças

The aim of the present study were: 1) To verify the relationship of vertical, horizontal and sextuple jumps with agility and velocity of 5, 10 and 25 m; 2) To verify the capacity of these jumps to predict the agility and 5, 10 and 25 m velocity performance in children. Twenty eight boys (9.47 ± 0.64 years) and thirty girls (9.69 ± 0.70 years) were evaluated. The correlation values between agility and velocity on 5, 10 and 25 m velocity were, respectively, r = 0.63, 0.51, 0.44 and 0.64 with vertical jump, r = 0.68, 0.62, 0.28 and 0.62 with sextuple jump, and r = 0.60, 0.50, 0.26 and 0.57 with horizontal jump. The vertical and sextuple jumps were able to predict the agility and 25 m velocity performance (p < 0.05). Furthermore, they demonstrated capacity to predict 5 and 10 m velocity, respectively (p < 0.05). The vertical and sextuple jump tests may be used for assessment and control of training with children practicing activities that require agility and velocity, since both jumps predicted the agility and velocity performance, which did not occur with the horizontal jump.Os objetivos do presente estudo foram: 1) verifi car a relação dos saltos vertical, horizontal e sêxtuplo com a agilidade e velocidade de 5, 10 e 25 m; 2) verifi car a capacidade desses saltos em predizer o desempenho da agilidade e velocidade de 5, 10 e 25 m em crianças. Vinte e oito meninos (9,47 ± 0,64 anos) e 30 meninas (9,69 ± 0,70 anos) foram avaliados. Os valores de correlação entre a agilidade, velocidade de 5, 10 e 25 m foram, respectivamente, r = 0,63, 0,51, 0,44 e 0,64 com o salto vertical, r = 0,68, 0,62, 0,28 e 0,62 com o salto sêxtuplo, e r = 0,60, 0,50, 0,26 e 0,57 com o salto horizontal. O salto vertical e o salto sêxtuplo foram capazes de predizer o desempenho da agilidade e da velocidade de 25 m (p < 0,05). Além disso, demonstraram capacidade de predizer a velocidade de 5 e 10 m, respectivamente (p < 0,05). Os testes de salto vertical e sêxtuplo podem ser utilizados para avaliação e controle do treinamento com crianças praticantes de atividades que demandam agilidade e velocidade, uma vez que ambos os saltos predisseram o desempenho da agilidade e velocidade, o que não ocorreu com o salto horizontal