Department of Ophthalmology, Centro Hospitalar Universitário São João, Porto, Portugal.
Department of Ophthalmology of São João Hospital, Avenida Prof. Hernâni Monteiro, 4202 - 451, Porto, Portugal.
Sci Rep. 2021 Oct 26;11(1):21079. doi: 10.1038/s41598-021-00649-0.
Numerous approaches have been designated to document progression in keratoconus, nevertheless there is no consistent or clear definition of ectasia progression. In this present study, we aim to evaluate Keratoconus Enlargement (KCE) as a parameter to document ectasia progression. We define KCE as an increase of more than 1D in the anterior curvature of non-apical corneal areas. We have designed a longitudinal study in 113 keratoconic eyes to assess keratoconus progression. KCE was compared with variables commonly used for detection of keratoconus progression like Kmax, Km, K2, PachyMin, D-Index, Corneal Astigmatism and PRC of 3.0 mm centered on the thinnest point. The variations of keratometric readings, D-index and ELEBmax showed positive associations with KCE. Evaluating the performance of Kmax, D-index and KCE as isolated parameters to document keratoconus progression we found a sensitivity of 49%, 82% and 77% and a specificity of 100%, 95% and 66% to detect keratoconus progression (p < 0.001 for all). This difference in sensitivity can be explained by the changes in keratoconus outside the small area represented by Kmax. The inclusion of KCE should be considered in the evaluation of keratoconus progression in conjunction with other variables to increase the reliability of our clinical evaluation.
已经有许多方法被指定用于记录圆锥角膜的进展，但对于扩张的进展还没有一致或明确的定义。在本研究中，我们旨在评估角膜扩张（KCE）作为记录扩张进展的参数。我们将 KCE 定义为非顶点角膜区域前曲率增加超过 1D。我们设计了一项针对 113 只圆锥角膜眼的纵向研究，以评估圆锥角膜的进展。将 KCE 与常用于检测圆锥角膜进展的变量进行比较，如 Kmax、Km、K2、PachyMin、D-Index、角膜散光和以最薄点为中心的 3.0mm 处的 PRC。角膜曲率读数、D-index 和 ELEBmax 的变化与 KCE 呈正相关。评估 Kmax、D-index 和 KCE 作为单独的参数来记录圆锥角膜的进展，我们发现它们的敏感性分别为 49%、82%和 77%，特异性分别为 100%、95%和 66%（所有 P 值均<0.001）。这种敏感性的差异可以用 Kmax 所代表的小区域以外的圆锥角膜变化来解释。在评估圆锥角膜进展时，应考虑将 KCE 纳入评估，同时结合其他变量，以提高我们临床评估的可靠性。
