Öz
Amaç: Scheimpflug görüntüleme sistemi kullanarak, pediatrik ve erişkin keratokonus grupları arasındaki ön segment ölçümlerindeki farklılıkları belirlemek.
Gereç ve Yöntem: Retrospektif özellikteki bu çalışmaya 133 keratokonuslu hasta ve 101 sağlıklı kontrol olgusu dâhil edildi. Olgular pediatrik ve erişkin olmak üzere gruplandı. Ön kamara derinliği (ÖKD), ön kamara hacmi (ÖKH), ön kamara açısı (ÖKA), pakimetri, kornea hacmi (KH) ve maksimum keratometri (Kmaks) değerleri arasındaki farklılıklar bakımından yaş alt grupları karşılaştırıldı.
Bulgular: Yüz otuz üç keratokonuslu hastanın (56 pediatrik ve 77 erişkin) ve 101 sağlıklı olgunun (41 pediatrik ve 60 erişkin) sağ gözleri incelendi. Her iki grupta, pediatrik olgular erişkin grup ile karşılaştırıldığında daha yüksek ÖKD ve ÖKV değerlerine sahipti (p<0.05). Diğer taraftan, keratokonuslu pediatrik ve erişkin olguların yaş-eşleştirmeli sağlıklı kontrol olgularına kıyasla daha yüksek ÖKD değerine sahip olduğu görüldü (p<0.05). Pediatrik grupta, evre 3 keratokonuslu olgular evre 2 keratokonuslu olgulara göre daha yüksek ÖKD değerine sahipti (p<0.05). Erişkin grupta ise evre 3 keratokonuslu hastaların evre 2 keratokonuslu hastalara göre daha düşük korneal ölçüm değerlerine sahip olduğu saptandı (p<0.05).-
Sonuç: Keratokonus ve kontrol gruplarında yaşla beraber ön kamara parametrelerinin değiştiği görülmektedir. Ancak, tüm yaş gruplarında keratokonuslu gözlerin yaş-eşleştirmeli sağlıklı kontrollere göre daha derin ön kamaraya sahip olduğu anlaşılmaktadır. Ayrıca, pediatrik keratokonus olgularında ÖKD değerindeki artma ilerleme açısından işaret edici olabilir. Diğer taraftan, erişkin keratokonus olgularında hastalık ilerlemesi ile sadece korneal parametre değerlerinin azaldığı görüşündeyiz.
Anahtar Kelimeler
Kaynakça
- Rabinowitz YS. Keratoconus. Surv Ophthalmol 1998;42(4):297-319.
- Kankariya VP, Kymionis GD, Diakonis VF, et al. Management of pediatric keratoconus - evolving role of corneal collagen cross-linking: An update. Indian J Ophthalmol 2013;61(8):435-40.
- Toprak I, Yaylalı V, Yildirim C. Factors affecting outcomes of corneal collagen crosslinking treatment. Eye 2014;28(1):41-6.
- Vinciguerra P, Albé E, Frueh BE, Trazza S, Epstein D. Two-year corneal cross-linking results in patients younger than 18 years with documented progressive keratoconus. Am J Ophthalmol 2012;154(3):520-6.
- Caporossi A, Mazzotta C, Baiocchi S, Caporossi T, Denaro R, Balestrazzi A. Riboflavin-UVA-induced corneal collagen cross-linking in pediatric patients. Cornea 2012;31(3):227-31.
- Rabsilber TM, Khoramnia R, Auffarth GU. Anterior chamber measurements using Pentacam rotating Scheimpflug camera. J Cataract Refract Surg 2006;32(3):456-9.
- Belin MW, Ambrósio R. Scheimpflug imaging for keratoconus and ectatic disease. Indian J Ophthalmol 2013;61(8):401-6.
- Bühren J, Kook D, Yoon G, Kohnen T. Detection of subclinical keratoconus by using corneal anterior and posterior surface aberrations and thickness spatial profiles. Invest. Ophthalmol Vis Sci 2010;51(7):3424-32.
- Emre S, Doganay S, Yologlu S. Evaluation of anterior segment parameters in keratoconic eyes measured with the Pentacam system. J Cataract Refract Surg 2007;33(10):1708-12.
- Edmonds CR, Wung SF, Pemberton B, Surrett S. Comparison of anterior chamber depth of normal and keratoconus eyes using Scheimpflug photography. Eye Contact Lens 2009;35(3):120-2.
- Zadnik K, Barr JT, Gordon MO, Edrington TB. Biomicroscopic signs and disease severity in keratoconus. Collaborative Longitudinal Evaluation of Keratoconus (CLEK) Study Group. Cornea 1996;15(2):139-46.
- Kamiya K, Ishii R, Shimizu K, Igarashi A. Evaluation of corneal elevation, pachymetry and keratometry in keratoconic eyes with respect to the stage of Amsler-Krumeich classification. Br J Ophthalmol 2014;98(4):459-63.
- Buehl W, Stojanac D, Sacu S, Drexler W, Findl O. Comparison of three methods of measuring corneal thickness and anterior chamber depth. Am J Ophthalmol 2006;141(1):7-12.
- Meinhardt B, Stachs O, Stave J, Beck R, Guthoff R. Evaluation of biometric methods for measuring the anterior chamber depth in the non-contact mode. Graefes Arch Clin Exp Ophthalmol 2006;244(5):559-64.
- Barkana Y, Gerber Y, Elbaz U, Schwartz S, Ken-Dror G, Avni I, et al. Central corneal thickness measurement with the Pentacam Scheimpflug system, optical low-coherence reflectometry pachymeter, and ultrasound pachymetry. J Cataract Refract Surg 2005;31(9):1729-35.
- Lackner B, Schmidinger G, Skorpik C. Validity and repeatability of anterior chamber depth measurements with Pentacam and Orbscan. Optom Vis Sci 2005;82(9):858-61.
- Kovacs I, Mihaltz K, Nemeth J, Nagy ZZ. Anterior chamber characteristics of keratoconus assessed by rotating Scheimpflug imaging. J Cataract Refract Surg 2010;36(7):1101-06.
- Fontes BM, Ambrosio R Jr, Jardim D, Velarde GC, Nosé W. Corneal biomechanical metrics and anterior segment parameters in mild keratoconus. Ophthalmology 2010;117(4):673-9.
- Sahebjada S, Xie J, Chan E, Snibson G, Daniel M, Baird PN. Assessment of anterior segment parameters of keratoconus eyes in an Australian population. Optom Vis Sci 2014;91(7):803-9.
- Xu L, Cao WF, Wang YX, Chen CX, Jonas JB. Anterior chamber depth and chamber angle and their associations with ocular and general parameters: the Beijing Eye Study. Am J Ophthalmol 2008;145(5):929-36.
Öz
Materials and Methods: This retrospective study included 133 patients with keratoconus and 101 healthy controls. Subjects were grouped as pediatric and adult. Differences in anterior chamber depth (ACD), anterior chamber volume (ACV), anterior chamber angle (ACA), pachymetry, corneal volume (CV) and maximum keratometry (Kmax) were sought between the age-based subgroups.
Results: Right eyes of the 133 keratoconus patients (56 pediatrics and 77 adults) and 101 healthy controls (41 pediatrics and 60 adults) were reviewed. Pediatric subgroups had significantly higher ACD and ACV compared to those of the adult subgroups in both groups (p<0.05). On the other hand, pediatric and adult keratoconus patients had significantly higher ACD than in the age (subgroup) matched controls (p< 0.05). In the pediatric keratoconus subgroup, eyes with stage 3 keratoconus had significantly deeper ACD than in the eyes with stage 2 keratoconus (p<0.05). However, in the adult group, only corneal parameters were significantly lower in eyes with stage 3 keratoconus compared to those of the eyes with stage 2 keratoconus (p<0.05).
Conclusion: Anterior chamber measurements appear to be altered by aging in both keratoconus and control groups, whereas eyes with keratoconus in all age subgroups appear to have a deeper AC than in the age-matched normals. Moreover, an increase in ACD in pediatric keratoconus might be indicative of progression. However, in the adult keratoconus, corneal parameters appear to decrease with keratoconus progression.
Anahtar Kelimeler
Kaynakça
- Rabinowitz YS. Keratoconus. Surv Ophthalmol 1998;42(4):297-319.
- Kankariya VP, Kymionis GD, Diakonis VF, et al. Management of pediatric keratoconus - evolving role of corneal collagen cross-linking: An update. Indian J Ophthalmol 2013;61(8):435-40.
- Toprak I, Yaylalı V, Yildirim C. Factors affecting outcomes of corneal collagen crosslinking treatment. Eye 2014;28(1):41-6.
- Vinciguerra P, Albé E, Frueh BE, Trazza S, Epstein D. Two-year corneal cross-linking results in patients younger than 18 years with documented progressive keratoconus. Am J Ophthalmol 2012;154(3):520-6.
- Caporossi A, Mazzotta C, Baiocchi S, Caporossi T, Denaro R, Balestrazzi A. Riboflavin-UVA-induced corneal collagen cross-linking in pediatric patients. Cornea 2012;31(3):227-31.
- Rabsilber TM, Khoramnia R, Auffarth GU. Anterior chamber measurements using Pentacam rotating Scheimpflug camera. J Cataract Refract Surg 2006;32(3):456-9.
- Belin MW, Ambrósio R. Scheimpflug imaging for keratoconus and ectatic disease. Indian J Ophthalmol 2013;61(8):401-6.
- Bühren J, Kook D, Yoon G, Kohnen T. Detection of subclinical keratoconus by using corneal anterior and posterior surface aberrations and thickness spatial profiles. Invest. Ophthalmol Vis Sci 2010;51(7):3424-32.
- Emre S, Doganay S, Yologlu S. Evaluation of anterior segment parameters in keratoconic eyes measured with the Pentacam system. J Cataract Refract Surg 2007;33(10):1708-12.
- Edmonds CR, Wung SF, Pemberton B, Surrett S. Comparison of anterior chamber depth of normal and keratoconus eyes using Scheimpflug photography. Eye Contact Lens 2009;35(3):120-2.
- Zadnik K, Barr JT, Gordon MO, Edrington TB. Biomicroscopic signs and disease severity in keratoconus. Collaborative Longitudinal Evaluation of Keratoconus (CLEK) Study Group. Cornea 1996;15(2):139-46.
- Kamiya K, Ishii R, Shimizu K, Igarashi A. Evaluation of corneal elevation, pachymetry and keratometry in keratoconic eyes with respect to the stage of Amsler-Krumeich classification. Br J Ophthalmol 2014;98(4):459-63.
- Buehl W, Stojanac D, Sacu S, Drexler W, Findl O. Comparison of three methods of measuring corneal thickness and anterior chamber depth. Am J Ophthalmol 2006;141(1):7-12.
- Meinhardt B, Stachs O, Stave J, Beck R, Guthoff R. Evaluation of biometric methods for measuring the anterior chamber depth in the non-contact mode. Graefes Arch Clin Exp Ophthalmol 2006;244(5):559-64.
- Barkana Y, Gerber Y, Elbaz U, Schwartz S, Ken-Dror G, Avni I, et al. Central corneal thickness measurement with the Pentacam Scheimpflug system, optical low-coherence reflectometry pachymeter, and ultrasound pachymetry. J Cataract Refract Surg 2005;31(9):1729-35.
- Lackner B, Schmidinger G, Skorpik C. Validity and repeatability of anterior chamber depth measurements with Pentacam and Orbscan. Optom Vis Sci 2005;82(9):858-61.
- Kovacs I, Mihaltz K, Nemeth J, Nagy ZZ. Anterior chamber characteristics of keratoconus assessed by rotating Scheimpflug imaging. J Cataract Refract Surg 2010;36(7):1101-06.
- Fontes BM, Ambrosio R Jr, Jardim D, Velarde GC, Nosé W. Corneal biomechanical metrics and anterior segment parameters in mild keratoconus. Ophthalmology 2010;117(4):673-9.
- Sahebjada S, Xie J, Chan E, Snibson G, Daniel M, Baird PN. Assessment of anterior segment parameters of keratoconus eyes in an Australian population. Optom Vis Sci 2014;91(7):803-9.
- Xu L, Cao WF, Wang YX, Chen CX, Jonas JB. Anterior chamber depth and chamber angle and their associations with ocular and general parameters: the Beijing Eye Study. Am J Ophthalmol 2008;145(5):929-36.
Ayrıntılar
| Birincil Dil | İngilizce |
|---|---|
| Konular | Sağlık Kurumları Yönetimi |
| Bölüm | Araştırma Makaleleri |
| Yazarlar | |
| Yayımlanma Tarihi | 1 Mart 2018 |
| Gönderilme Tarihi | 30 Ağustos 2016 |
| Yayımlandığı Sayı | Yıl 2018Cilt: 57 Sayı: 1 |
