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Strategies for improving the early diagnosis of keratoconus

Authors Shi Y

Received 27 August 2015

Accepted for publication 12 November 2015

Published 24 February 2016 Volume 2016:8 Pages 13—21


Checked for plagiarism Yes

Review by Single-blind

Peer reviewer comments 2

Editor who approved publication: Mr Simon Berry

Yue Shi

Doheny Eye Institute, Department of Ophthalmology, David Geffen School of Medicine, University of California at Los Angeles, Los Angeles, CA, USA

Abstract: To diagnose keratoconus at its earliest stage is meaningful in order to avoid refractive surgery in the eye, which may lead to further damage in the abnormal cornea structure and consequently cause iatrogenic ectasia. In this article, the following aspects of detecting earliest stage of keratoconus were reviewed: 1) nomenclature of the earliest forms of keratoconus; 2) diagnosis of keratoconus using curvature-based topography (also known as Placido-based topography, ie, videokeratography) as a traditional method and elevation-based topography as a new method which has gained popularity in recent years; and 3) other methods analyzing keratoconus cornea like corneal biomechanics and wavefront sensing. Elevation-based topography using either Scheimpflug imaging techniques or slit-scanning imaging techniques has shown to be advantageous over the curvature-based topography in detecting keratoconus at its earliest stage. Posterior elevation of the cornea is notified to enhance the sensitivity and specificity of detection if used along with the measurements of anterior surface of the cornea. Cornea biomechanics analysis and wavefront sensing also revealed differences between normal eyes and keratoconic eyes in their earliest stage. Combining the latest technology and the traditional techniques will be the future trend to improve early diagnosis of keratoconus.

Keywords: keratoconus, early diagnosis, Scheimpflug imaging, slit-scanning imaging, wavefront error, corneal biomechanics

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