ArticleOphthalmology science
Eccentric Pathology in Keratoconus Exhibits Stiffer Biomechanical Response than Central Pathology.
Article in Ophthalmology science. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
Purpose: To investigate the difference in biomechanical response metrics between central and eccentric pathology and compare axial vs. tangential curvature, as well as zonal vs. single-point values. Design: Prospective, observational, cross-sectional study. Participants: The study included 67 eyes of 41 subjects diagnosed with keratoconus (KCN). Methods: Pentacam tomography and Corvis ST examinations were acquired, and disease severity was defined by maximum curvature, comparing single point of maximum anterior axial curvature (Kmax) vs. magnitude of surrounding 2 mm zonal value (ZKmax) on axial maps, vs. magnitude of steepest 2 mm zone on axial (CSpot_Axi) and tangential (CSpot_Tan) maps located by Cone Location and Magnitude Index (CLMI). Distance between the corneal center and Kmax (Kmax_dist) was compared to radial distance with CLMI (CRad_Axi and CRad_Tan). Single-point Kmax, ZKmax, and CLMI-derived zones were compared with biomechanical metrics via regression analyses, including stiffness parameter at first applanation (SP-A1), deformation amplitude ratio at 2 mm (DA Ratio), integrated inverse radius (IIR), and stress-strain index (SSI). Measurements were analyzed using paired Main Outcome Measures: Maximum curvature using axial vs. tangential curvature, zonal vs. single-point curvature, and corneal stiffness metrics compared with cone location. Results: Significantly greater central pathology was found using tangential (58 central and 9 eccentric) vs. axial curvature (28 central and 39 eccentric). ZKmax was significantly different than CSpot_Axi and CSpot_Tan ( Conclusions: Central pathology has greater frequency with tangential than axial curvature. Corneal stiffness increases as the distance of the cone from the center increases, consistent with the focal nature of KCN. Central stiffness decreases as cone curvature (disease severity) increases. Recommendation is to use zonal values with tangential curvature to evaluate the location of the greatest curvature and changes in curvature over time. Financial Disclosures: Proprietary or commercial disclosure may be found in the Footnotes and Disclosures at the end of this article.
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