Differentiating Keratoconus and Corneal Warpage by Analyzing Focal Change Patterns in Corneal Topography, Pachymetry, and Epithelial. Cont Lens Anterior Eye. Sep;26(3) Hydrogel contact lens-induced corneal warpage. Schornack M(1). Author information: (1)Department of. Before the advent of corneal topography, corneal warpage was generally described as a condition that included distorted keratometer mires.

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Subclinical keratoconus detection by pattern analysis of corneal and epithelial thickness maps with optical coherence tomography.

Hydrogel contact lens-induced corneal warpage.

The sagging of the cornea contributes to the vertical inferior displacement of the thinnest point, which is one of the earliest signs of the permanent warpage caused by ccorneal rubbing. On the other hand, an abnormal i. There is no protrusion here, as demonstrated by the raw image of the vertical slice taken by cornexl Scheimpflug camera.

Clinical signs of corneal warpage include changes in refractive error, decreased visual acuity with spectacle correction, and changes in corneal topography. To specifically diagnose keratoconus, combining pattern analysis of focal changes in different maps is needed, as has been pointed out in the global consensus definition of keratoconus and ectasia.

The system works at an nm wavelength and has a scanning speed of 26, axial scans per second. More recent studies have shown that corneal pachymetry 5 — 8 and epithelial thickness maps 9 — 13 can be more sensitive than Placido topography for keratoconus diagnosis.

Identifying progression of subclinical keratoconus by serial topography analysis. The pachymetry and epithelial thickness maps were also centered on the pupil center.


We used the Gaussian waveform, which was cone shaped, to fit the focal ectasia. HuangOptovue Inc. The values of the three parameters were compared between groups. Additionally, the OCT scans used in this study only covered central 6-mm diameter corneal area.

The novel Anterior Ectasia Index and Warpage Indices can be used to warpagw between keratoconus and warpage. It is calculated by the dot product of the PD maps of anterior topography and epithelial thickness Equation 1. In response to eye rubbing, the buckling and flexure of the corneal fibrils may occur in association with the slippage between collagen fibrils at the cone apex.

Using Anterior Ectasia Index of 6. The epithelial PSD was normal 0. Correlation between epithelial thickness in normal corneas, untreated ectatic corneas, and ectatic corneas previously treated with CXL; is overall epithelial thickness a very early ectasia prognostic factor?

They can be differentiated by the OCT epithelial map, which shows matching focal thickening in warpage and thinning in keratoconus. Novel pachymetric parameters based on corneal tomography for diagnosing keratoconus. Similarly, though Warpage index is positive in all warpage eyes and normal in most keratoconus eyes, it fails in cases where keratoconus and warpage coexist.

However, topography is not sensitive to very early stages of keratoconus when the topographic steepening is masked by focal epithelial thinning. The topography maps were repositioned to be centered on the pupil center. Keratoconus subjects included in this study were diagnosed clinically with the following inclusion criteria: This system projects 40 optical slits, 20 from the right and 20 from the left, onto the cornea at a degree angle.


Positive Warpage Index indicates warpage, and negative Warpage Index indicates keratoconus, as shown in Figure 1. Several new tools have been developed to make the detection of FFK more reliable.

Ectasia or permanent corneal warpage? | Defeat Keratoconus

The zone exposed to the trauma from the fingers is often located inferiorly with regards to the geometric center of the cornea. Rabinowitz YS, Rasheed K. Tripartite classification between normal, warpage, and ectasia requires using both new indices together with the epithelial PSD. Characteristics of keratoconus and pellucid marginal degeneration in mean curvature maps.

You must be signed into an individual account to use this feature. Intrinsic position uncertainty impairs overt search performance. Scheimpflug corneal topography revealed the presence of bilateral inferior steepening, more pronounced in the right eye. While the inferior part of the cornea sags and steepensthe superior part of the cornea flattens.

Certain individuals who wear hydrogel contact lenses can experience corneal warpage. The purple area indicates both conditions coexist. In all three cases, cessation of lens wear warpagr to restoration of the normal corneal contour and visual acuity.

Contact lens-related warpage top and keratoconus bottom are not distinguishable by anterior topography i.