These tools will no longer be maintained as of December 31, 2024. Archived website can be found here. PubMed4Hh GitHub repository can be found here. Contact NLM Customer Service if you have questions.


Pubmed for Handhelds

PUBMED FOR HANDHELDS

Search MEDLINE/PubMed

  • Title: Children with high astigmatism: tomographic and refractive characteristics and the ability of current indices to rule out keratoconus.
    Author: Abdul Fattah M, Mireskandari K, Fung SSM, Woo JH, Ali A.
    Journal: J AAPOS; 2023 Dec; 27(6):328.e1-328.e7. PubMed ID: 39195354.
    Abstract:
    PURPOSE: To assess corneal tomographic, topographic, and refractive changes in children with high astigmatism and their ability to exclude keratoconus. METHODS: In this longitudinal observational study, the medical records of children with high regular cylindrical refraction of ≥3.50 D referred to the Hospital for Sick Children, Toronto, to exclude keratoconus between January 2009 and June 2020 were reviewed retrospectively. Corneal tomography records (Scheimpflug imaging) were reviewed for subjects with total astigmatism of ≥ +3.50 D by retinoscopy. Children with abnormal anterior segment examination and/or other risk factors for corneal disease or ectasia and those with unreliable corneal tomography were excluded. Baseline demographic, longitudinal tomographic, topographic, and refractive data were analyzed. RESULTS: A total of 67 eyes of 37 children (mean age, 9.1 ± 3.5 years) were included. Mean cylindrical refraction at presentation was 5.10 ± 1.30 D. Mean follow-up was 2.3 ± 1.8 years. Twenty-nine eyes had Kmax ≥47.20 D at baseline, with no change at last follow-up. Ksteep, Kmax, and thinnest pachymetry were 46.44 ± 2.33 D, 47.06 ± 2.57 D, and 525.86 ± 35.45 μm, respectively, at baseline compared with 46.40 ± 2.28 D, 46.98 ± 2.40 D, and 527.61 ± 37.67 μm at last follow-up (P > 0.05). All eyes were predicted as not having keratoconus using inferior-superior dioptric asymmetry ratio (I-S ratio), and the keratometry, inferior-superior, and astigmatism index (KISA%), which also incorporates skew percentage. The other tomographic indices predicted keratoconus or subclinical keratoconus in at least 22.4% of eyes. All parameters did not significantly change during follow-up. CONCLUSIONS: In the absence of other risk factors for keratoconus, children with high regular astigmatism demonstrated clinical and tomographic stability over time. Based on our results, we recommend that I-S ratio and KISA% be primarily used when monitoring normal children with high astigmatism to rule out keratoconus-related changes.
    [Abstract] [Full Text] [Related] [New Search]