.: ORİJİNAL ARAŞTIRMA
Long Term Follow-Up of Unilateral Keratoconus Patients with Scheimpflug Camera
Tek Taraflı Keratokonusu Olan Hastaların Scheimpflug Kamera ile Uzun Dönem Takibi
Turkiye Klinikleri J Ophthalmol. 2020;29(2):121-8
doi: 10.5336/ophthal.2019-70207
Makale Dili: EN
Tam Metin
ABSTRACT
Objective: The aim of the present study was to represent the long term follow-up of unilateral keratoconus (KC) patients with rotating Scheimpflug camera. Material and Methods: Medical records of 919 KC follow- up patients were reviewed. A total of 16 patients with at least 12 months of follow-up period were recruited. The KC positive eyes constituted the 'KC group', normal fellow eyes constituted the 'fellow eye group', and 24 eyes of 24 normal age-matched subjects 'control group'. All subjects underwent a complete ophthalmologic examination and were evaluated by rotating Scheimpflug imaging system. Also, 9 patients with at least 36 months of follow- up were evaluated separately. Results: The mean ages of KC and control groups were 30.38±9.34, 31.62±8.49, respectively (p= 0.664). The mean follow- up time in KC and control groups were 38.13±38.86 and 13.45±2.08, respectively. Demographic factors were similar between groups. At baseline examination, keratometry values , inferior superior difference at 4 mm (I-S), topometric indices and corneal thickness at apex and the thinnest point were significantly different between KC group and fellow eye group (p<0.05 for all comparisons). In the longer follow-up of 9 eyes in KC group for a mean of 59.67±26.68 months, KC progressed in 2 eyes, however the fellow eyes of these 9 remained stable. Conclusion: Although KC is known to be asymmetrical but bilateral, unilateral diseases might also be detected. Follow-up of unilateral KC patients is important to discrimiate asymmetrical keratoconus, which requires early progression analysis for crosslinking decision to protect better vision from really healthy fellow eyes that do not need intervention.
Keywords: Cornea; corneal topography; keratoconus
Objective: The aim of the present study was to represent the long term follow-up of unilateral keratoconus (KC) patients with rotating Scheimpflug camera. Material and Methods: Medical records of 919 KC follow- up patients were reviewed. A total of 16 patients with at least 12 months of follow-up period were recruited. The KC positive eyes constituted the 'KC group', normal fellow eyes constituted the 'fellow eye group', and 24 eyes of 24 normal age-matched subjects 'control group'. All subjects underwent a complete ophthalmologic examination and were evaluated by rotating Scheimpflug imaging system. Also, 9 patients with at least 36 months of follow- up were evaluated separately. Results: The mean ages of KC and control groups were 30.38±9.34, 31.62±8.49, respectively (p= 0.664). The mean follow- up time in KC and control groups were 38.13±38.86 and 13.45±2.08, respectively. Demographic factors were similar between groups. At baseline examination, keratometry values , inferior superior difference at 4 mm (I-S), topometric indices and corneal thickness at apex and the thinnest point were significantly different between KC group and fellow eye group (p<0.05 for all comparisons). In the longer follow-up of 9 eyes in KC group for a mean of 59.67±26.68 months, KC progressed in 2 eyes, however the fellow eyes of these 9 remained stable. Conclusion: Although KC is known to be asymmetrical but bilateral, unilateral diseases might also be detected. Follow-up of unilateral KC patients is important to discrimiate asymmetrical keratoconus, which requires early progression analysis for crosslinking decision to protect better vision from really healthy fellow eyes that do not need intervention.
Keywords: Cornea; corneal topography; keratoconus
ÖZET
Amaç: Bu çalışmanın amacı tek teraflı keratokonusu (KK) olan hastaların dönen Scheimpflug kamera ile elde edilen uzun dönem takip sonuçlarının sunulmasıdır. Gereç ve Yöntemler: KK tanılı 919 hastanın tıbbi verileri incelendi. En az 12 ay takibi olan 16 hasta çalışmaya alındı. KK olan hastalar "KK grubu", normal gözleri "diğer göz grubu" ve yaş ve cinsiyet uyumlu 24 normal olgunun 24 gözü "kontrol grubu" olarak kabul edildi. Tüm katılımcılara tam oftalmolojik muayene ile beraber Scheimpflug görüntüleme yapıldı. Ayrıca, en az 36 ay takibi olan 9 hasta ayrıca değerlendirildi. Bulgular: KK grubunda ve kontrol grubunda ortalama yaş sırasıyla 30,38±9,34, 31,62±8,49 (p=0,664) idi. Ortalama takip süresi KK ve kontrol gruplarında sırasıyla 38,13±38,86 ve 13,45±2,08 aydı. Demografik veriler iki grup arasında benzerdi. İlk muayenede keratometri değerleri, 4 mm de inferior superior farkı (I-S), topometric topometrik indeksler, apekste ve en ince noktadaki korneal kalınlık KK grubu ile diğer göz grubu arasında anlamlı derecede farklıydı (tüm karşılaştırmalarda p<0,05). KK grubunda daha uzun süre takip edilen 9 hastada ortalama 59,67±26,68 ay ortalama takip süresince 2 hastada KK ilerledi ancak tüm hastaların diğer gözleri stabil seyretti. Sonuç: KK iki taraflı ancak asimetrik olarak bilinmekle beraber tek taraflı görülebilir. Herhangi bir girişim gerektirmeyen tek taraflı KK hastalarını, iyi bir görme sağlamada çapraz bağlama tedavi kararı için erken progresyon analiz gerektiren asimetrik KK hastalarından ayırmak önemlidir.
Anahtar Kelimeler: Keratokonus; kornea; korneal topografi
Amaç: Bu çalışmanın amacı tek teraflı keratokonusu (KK) olan hastaların dönen Scheimpflug kamera ile elde edilen uzun dönem takip sonuçlarının sunulmasıdır. Gereç ve Yöntemler: KK tanılı 919 hastanın tıbbi verileri incelendi. En az 12 ay takibi olan 16 hasta çalışmaya alındı. KK olan hastalar "KK grubu", normal gözleri "diğer göz grubu" ve yaş ve cinsiyet uyumlu 24 normal olgunun 24 gözü "kontrol grubu" olarak kabul edildi. Tüm katılımcılara tam oftalmolojik muayene ile beraber Scheimpflug görüntüleme yapıldı. Ayrıca, en az 36 ay takibi olan 9 hasta ayrıca değerlendirildi. Bulgular: KK grubunda ve kontrol grubunda ortalama yaş sırasıyla 30,38±9,34, 31,62±8,49 (p=0,664) idi. Ortalama takip süresi KK ve kontrol gruplarında sırasıyla 38,13±38,86 ve 13,45±2,08 aydı. Demografik veriler iki grup arasında benzerdi. İlk muayenede keratometri değerleri, 4 mm de inferior superior farkı (I-S), topometric topometrik indeksler, apekste ve en ince noktadaki korneal kalınlık KK grubu ile diğer göz grubu arasında anlamlı derecede farklıydı (tüm karşılaştırmalarda p<0,05). KK grubunda daha uzun süre takip edilen 9 hastada ortalama 59,67±26,68 ay ortalama takip süresince 2 hastada KK ilerledi ancak tüm hastaların diğer gözleri stabil seyretti. Sonuç: KK iki taraflı ancak asimetrik olarak bilinmekle beraber tek taraflı görülebilir. Herhangi bir girişim gerektirmeyen tek taraflı KK hastalarını, iyi bir görme sağlamada çapraz bağlama tedavi kararı için erken progresyon analiz gerektiren asimetrik KK hastalarından ayırmak önemlidir.
Anahtar Kelimeler: Keratokonus; kornea; korneal topografi
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