Astigmatic Vector Analysis of Posterior Cornea - a Comparison Among Healthy, Forme Fruste and Overt Keratoconus Corneas

NCT ID: NCT02698709

Last Updated: 2016-03-04

Study Results

Results pending

The study team has not published outcome measurements, participant flow, or safety data for this trial yet. Check back later for updates.

Basic Information

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Recruitment Status

COMPLETED

Total Enrollment

698 participants

Study Classification

OBSERVATIONAL

Study Start Date

2015-05-31

Study Completion Date

2015-09-30

Brief Summary

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The main purpose of this study is to determine new diagnostic criteria for an eye disease called keratoconus.

Detailed Description

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Eyes of patients who distinctly present signs of keratoconus, for both eyes, at corneal tomography (an exam commonly used in such cases), and those who present such signs in only one eye were compared to eyes of unaffected patients. Several characteristics of anterior and posterior corneal astigmatism (special emphasis was given to the latter) were collectively assessed among all patients by a method referred to as vectorial analysis. Statistical tests were then performed, in an attempt to highlight differences among those three groups of patients and, eventually, define new diagnostic criteria.

Conditions

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Keratoconus

Study Design

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Observational Model Type

CASE_CONTROL

Study Time Perspective

RETROSPECTIVE

Study Groups

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Healthy corneas (C)

Corneas of normal candidates to refractive surgery who did not develop any sign of corneal ectasia after laser in situ keratomileusis during a two year follow-up period were analyzed by an Scheimpflug-based tomographer. Vector astigmatism analysis of anterior and posterior corneal surfaces were studied in accordance to method proposed by Thibos.

Analysis of anterior and posterior corneal surfaces

Intervention Type OTHER

Corneal data obtained from a Scheimpflug-based topographer were converted to astigmatic vectors in accordance to the method proposed by Thibos

Overt keratoconus (Kc)

Whether both eyes manifested classic Kc-suggestive topographic features, such as corneal steepness higher than 47.20 diopters (D), superior-inferior asymmetry higher than 1.40 D and thinnest pachymetric reading lower than 500 micrometers. Such eyes were analyzed by an Scheimpflug-based tomographer. Vector astigmatism analysis of anterior and posterior corneal surfaces were studied in accordance to method proposed by Thibos.

Analysis of anterior and posterior corneal surfaces

Intervention Type OTHER

Corneal data obtained from a Scheimpflug-based topographer were converted to astigmatic vectors in accordance to the method proposed by Thibos

Forme fruste keratoconus (FFKc)

Whether only one eye manifested classic Kc-suggestive topographic features, such as corneal steepness higher than 47.20 diopters (D), superior-inferior asymmetry higher than 1.40 D and thinnest pachymetric reading lower than 500 micrometers, and the fellow eye seemed unaffected. Such unaffected eyes were analyzed by an Scheimpflug-based tomographer. Vector astigmatism analysis of anterior and posterior corneal surfaces were studied in accordance to method proposed by Thibos.

Analysis of anterior and posterior corneal surfaces

Intervention Type OTHER

Corneal data obtained from a Scheimpflug-based topographer were converted to astigmatic vectors in accordance to the method proposed by Thibos

Interventions

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Analysis of anterior and posterior corneal surfaces

Corneal data obtained from a Scheimpflug-based topographer were converted to astigmatic vectors in accordance to the method proposed by Thibos

Intervention Type OTHER

Other Intervention Names

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Thibos' vectorial astigmatism analysis

Eligibility Criteria

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Inclusion Criteria

* Good-quality Scheimpflug scans (approved by the device in the ''Examination Quality Specification'').

Exclusion Criteria

* Previous eye surgery or trauma, and any sort of corneal scarring that might interfere with keratometric data acquisition.
Eligible Sex

ALL

Accepts Healthy Volunteers

No

Sponsors

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University of Sao Paulo

OTHER

Sponsor Role lead

Responsible Party

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Giuliano de Oliveira Freitas, MD.

MD

Responsibility Role PRINCIPAL_INVESTIGATOR

Principal Investigators

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Milton R Alves, MD, PhD

Role: STUDY_DIRECTOR

Clínica Oftalmológica HCFM/USP

Locations

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Clínica Oftalmológica do Hospital de Clínicas - FMUSP

São Paulo, São Paulo, Brazil

Site Status

Countries

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Brazil

References

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Li X, Yang H, Rabinowitz YS. Keratoconus: classification scheme based on videokeratography and clinical signs. J Cataract Refract Surg. 2009 Sep;35(9):1597-603. doi: 10.1016/j.jcrs.2009.03.050.

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Goebels S, Eppig T, Wagenpfeil S, Cayless A, Seitz B, Langenbucher A. Staging of keratoconus indices regarding tomography, topography, and biomechanical measurements. Am J Ophthalmol. 2015 Apr;159(4):733-8. doi: 10.1016/j.ajo.2015.01.014. Epub 2015 Jan 26.

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Gomes JA, Tan D, Rapuano CJ, Belin MW, Ambrosio R Jr, Guell JL, Malecaze F, Nishida K, Sangwan VS; Group of Panelists for the Global Delphi Panel of Keratoconus and Ectatic Diseases. Global consensus on keratoconus and ectatic diseases. Cornea. 2015 Apr;34(4):359-69. doi: 10.1097/ICO.0000000000000408.

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Muftuoglu O, Ayar O, Ozulken K, Ozyol E, Akinci A. Posterior corneal elevation and back difference corneal elevation in diagnosing forme fruste keratoconus in the fellow eyes of unilateral keratoconus patients. J Cataract Refract Surg. 2013 Sep;39(9):1348-57. doi: 10.1016/j.jcrs.2013.03.023. Epub 2013 Jun 29.

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Torricelli AA, Bechara SJ, Wilson SE. Screening of refractive surgery candidates for LASIK and PRK. Cornea. 2014 Oct;33(10):1051-5. doi: 10.1097/ICO.0000000000000171.

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Randleman JB, Akhtar J, Lynn MJ, Ambrosio R Jr, Dupps WJ Jr, Krueger RR, Klyce SD. Comparison of objective and subjective refractive surgery screening parameters between regular and high-resolution Scheimpflug imaging devices. J Cataract Refract Surg. 2015 Feb;41(2):286-94. doi: 10.1016/j.jcrs.2014.06.026. Epub 2014 Dec 20.

Reference Type RESULT
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Ramos IC, Correa R, Guerra FP, Trattler W, Belin MW, Klyce SD, Fontes BM, Schor P, Smolek MK, Dawson DG, Chalita MR, Cazal JO, Ruiz M, Randleman JB, Ambrosio R Jr. Variability of subjective classifications of corneal topography maps from LASIK candidates. J Refract Surg. 2013 Nov;29(11):770-5. doi: 10.3928/1081597X-20130823-01. Epub 2013 Aug 30.

Reference Type RESULT
PMID: 23980708 (View on PubMed)

Qin B, Chen S, Brass R, Li Y, Tang M, Zhang X, Wang X, Wang Q, Huang D. Keratoconus diagnosis with optical coherence tomography-based pachymetric scoring system. J Cataract Refract Surg. 2013 Dec;39(12):1864-71. doi: 10.1016/j.jcrs.2013.05.048.

Reference Type RESULT
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Ruisenor Vazquez PR, Galletti JD, Minguez N, Delrivo M, Fuentes Bonthoux F, Pfortner T, Galletti JG. Pentacam Scheimpflug tomography findings in topographically normal patients and subclinical keratoconus cases. Am J Ophthalmol. 2014 Jul;158(1):32-40.e2. doi: 10.1016/j.ajo.2014.03.018. Epub 2014 Apr 5.

Reference Type RESULT
PMID: 24709808 (View on PubMed)

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Reference Type RESULT
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Galletti JD, Ruisenor Vazquez PR, Minguez N, Delrivo M, Bonthoux FF, Pfortner T, Galletti JG. Corneal asymmetry analysis by pentacam scheimpflug tomography for keratoconus diagnosis. J Refract Surg. 2015 Feb;31(2):116-23. doi: 10.3928/1081597X-20150122-07.

Reference Type RESULT
PMID: 25735045 (View on PubMed)

Ambrosio R Jr, Valbon BF, Faria-Correia F, Ramos I, Luz A. Scheimpflug imaging for laser refractive surgery. Curr Opin Ophthalmol. 2013 Jul;24(4):310-20. doi: 10.1097/ICU.0b013e3283622a94.

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Montalban R, Pinero DP, Javaloy J, Alio JL. Scheimpflug photography-based clinical characterization of the correlation of the corneal shape between the anterior and posterior corneal surfaces in the normal human eye. J Cataract Refract Surg. 2012 Nov;38(11):1925-33. doi: 10.1016/j.jcrs.2012.06.050. Epub 2012 Sep 14.

Reference Type RESULT
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Montalban R, Pinero DP, Javaloy J, Alio JL. Correlation of the corneal toricity between anterior and posterior corneal surfaces in the normal human eye. Cornea. 2013 Jun;32(6):791-8. doi: 10.1097/ICO.0b013e31827bf898.

Reference Type RESULT
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Pinero DP, Alio JL, Tomas J, Maldonado MJ, Teus MA, Barraquer RI. Vector analysis of evolutive corneal astigmatic changes in keratoconus. Invest Ophthalmol Vis Sci. 2011 Jun 8;52(7):4054-62. doi: 10.1167/iovs.10-6856.

Reference Type RESULT
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Reference Type RESULT
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Lopes B, Ramos I, Ambrosio R Jr. Corneal densitometry in keratoconus. Cornea. 2014 Dec;33(12):1282-6. doi: 10.1097/ICO.0000000000000266.

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McGee S. Simplifying likelihood ratios. J Gen Intern Med. 2002 Aug;17(8):646-9. doi: 10.1046/j.1525-1497.2002.10750.x.

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Shi R, Conrad SA. Correlation and regression analysis. Ann Allergy Asthma Immunol. 2009 Oct;103(4 Suppl 1):S35-41. doi: 10.1016/s1081-1206(10)60820-4. No abstract available.

Reference Type RESULT
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Other Identifiers

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Clínica Oftalmológica HCFM/USP

Identifier Type: -

Identifier Source: org_study_id

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