Cesk Slov Oftalmol. 2023 Fall;79(5):258-265. doi: 10.31348/2023/30.
To introduce the topic of pediatric keratoconus, highlighting the importance of routine corneal topography and tomography in children and adolescents from predisposed groups. To attempt to ensure the early detection of keratoconus and its subclinical form, enabling early treatment, which brings better expected postoperative results. Material and methods: Using the corneal tomograph Pentacam AXL we examined children and adolescents with astigmatism equal or greater than 2 diopters (in at least one eye) and patients with at least one risk factor such as eye rubbing in the case of allergic pathologies, positive family history of keratoconus or certain forms of retinal dystrophy. In total, we included 231 eyes (116 patients), of which 54 were girls and 62 were boys.
The Belin-Ambrósio deviation index parameter was evaluated, in which we classified a total of 41 eyes as subclinical keratoconus and 12 eyes as clinical keratoconus. Next, the corneal maps were evaluated individually, in which we included a total of 15 eyes as subclinical keratoconus and 6 eyes as clinical keratoconus. In our group, compared to the control group, subclinical and clinical keratoconus occurred most often in the group of patients with astigmatism and in the group of so-called "eye rubbers". After individual evaluation, keratoconus occurred more frequently in boys than in girls in our cohort.
Most patients with keratoconus are diagnosed when there is a deterioration of visual acuity and changes on the anterior surface of the cornea. Corneal topography and tomography allows us to monitor the initial changes on the posterior surface of the cornea, and helps us to detect the subclinical form of keratoconus and the possibility of its early treatment. Therefore, it is important to determine which groups are at risk and groups in which corneal topography and tomography should be performed routinely.
介绍儿童圆锥角膜的相关内容，强调对有患病倾向的儿童和青少年群体进行常规角膜地形和断层扫描的重要性。旨在尽早发现圆锥角膜及其亚临床形式，从而能够尽早进行治疗，以获得更好的术后预期效果。
我们使用角膜断层扫描仪 Pentacam AXL 检查了散光≥2 屈光度（至少一眼）的儿童和青少年，以及患有眼摩擦（例如过敏病理）、圆锥角膜阳性家族史或某些形式的视网膜营养不良等至少一个危险因素的患者。共有 231 只眼（116 例患者）纳入研究，其中女孩 54 例，男孩 62 例。
评估了 Belin-Ambrósio 偏离指数参数，我们将总共 41 只眼归类为亚临床圆锥角膜，12 只眼归类为临床圆锥角膜。接下来，我们分别评估了角膜图，总共纳入了 15 只眼为亚临床圆锥角膜，6 只眼为临床圆锥角膜。在我们的研究组中，与对照组相比，亚临床和临床圆锥角膜在散光患者组和所谓的“揉眼者”组中更为常见。在我们的队列中，与女孩相比，男孩中亚临床和临床圆锥角膜更为常见。
大多数圆锥角膜患者在视力下降和角膜前表面改变时才被确诊。角膜地形和断层扫描可帮助我们监测角膜后表面的初始变化，有助于发现圆锥角膜的亚临床形式并尽早治疗。因此，确定高危人群和需要常规进行角膜地形和断层扫描的人群非常重要。
