The variability of corneal and anterior segment parameters in keratoconus

Purpose: To analyse, describe and test diverse corneal and anterior segment parameters in normal and keratoconic eyes to better understand the geometry of the keratoconic cornea. Method: 44 eyes from 44 keratoconic patients and 44 eyes from 44 healthy patients were included in the study. The Pentacam System was used for the analysis of the anterior segment parameters. New ad-hoc parameters were defined by measuring the distances on the Scheimpflug image at the horizontal diameter, with chamber depth now comprising of two distinctive distances: corneal sagittal depth and the distance from the endpoint of this segment to the anterior surface of the lens (DL). Results: Statistically significant differences (p<0.05) between normal and keratoconic eyes were found in all of the analysed corneal parameters. Anterior chamber depth presented statistical differences between normal and keratoconic eyes (3.06 ± 0.43 mm versus 3.34 ± 0.45 mm, respectively; p = 0.004). This difference was found to originate in an increase of the DL distance (0.40 ± 0.33 mm in normal eyes against 0.61 ± 0.45 mm in keratoconic eyes; p = 0.014), rather than in the changes in corneal sagittal depth. Conclusion: These findings indicate that keratoconus results in central and peripheral corneal manifestations, as well as changes in the shape of the scleral limbus. The DL parameter was useful in describing the forward elongation and advance of the scleral tissue in keratoconic eyes. This finding may help in the monitoring of disease progression and contact lens design and fitting.Preprin

Anterior chamber parameters in early and advanced keratoconus. A meridian by meridian analysis

Purpose: To explore anterior segment changes with keratoconus onset and progression to determine whether structural changes are predominantly corneal, limbal or both. To investigate these changes in different corneal meridians. Method: Eighty-four eyes with keratoconus and 49 healthy eyes were included in the study. Eyes with keratoconus were divided in two groups according to the Amsler-Krumeich classification: stage I and stages II-IV. Scheimpflug images at three different meridians were used to evaluate the following parameters: anterior chamber depth from the endothelium (ACD_end) and corneal thickness (CT) (software provided), anterior chamber depth (ACD) and sagittal depth (SAGT) from the epithelium, and distance from the end point of SAGT to the anterior surface of the lens (DL) (measured manually), and [ACD – CT] and [SAGT – CT] (calculated). Changes in these parameters with ocular condition and meridian were analysed. Results: Statistically significant larger values were found of ACD (p=0.012) and DL (p=0.016) with keratoconus onset and progression, with no differences in SAGT values. Besides, [ACD – CT] and [SAGT – CT] were significantly larger in keratoconus eyes (p<0.001 and p=0.003, respectively). Significant differences (all p<0.001) were found in SAGT, [SAGT – CT] and DL among meridians. Changes in these parameters with keratoconus onset and progression were similar in all meridians. Conclusion: Considering the results from the three meridians under investigation, it may be concluded that keratoconus onset has an impact on the anterior segment as a whole and not only on corneal structures. The DL distance is a useful parameter to describe limbal changes in keratoconus.Postprint (author's final draft

Comparative analysis of peripheral corneal geometry in health and Keratoconus

OBJECTIVES:: To describe and compare corneal peripheral angles in normal and keratoconic eyes, to gain a better understanding of the topography of the periphery of the cornea in keratoconus and assist practitioners in the selection and fitting of large diameter contact lenses. METHODS:: Eighty-eight eyes were included in the study, divided into three groups: healthy (A0, 28 eyes), keratoconus at stage I according to the Amsler-Krumeich classification (AI, 33 eyes) and keratoconus at stages II to IV (AII, 27 eyes). The Pentacam Scheimpflug system was used to manually measure the corneal peripheral angles corresponding to a chord length range between 8.6 and 12.6 mm at 8 different peripheral locations. RESULTS:: The peripheral angle was influenced by ocular condition and by the peripheral location, with no interaction effect between both factors. Statistically significant differences were found in mean corneal peripheral angles between groups A0 (30.84°±2.33°) and AI (31.63°±2.02°) (P=0.001) and between A0 and AII (31.37°±2.11°) (P=0.030). The differences between AI and AII were not significant. In all eyes, the largest and smallest peripheral angles were found at the temporal inferior and temporal superior locations, respectively, with a mean difference between largest and smallest of 3.37°±1.42° in healthy eyes and 2.96°±1.54° in keratoconus (AI+AII). CONCLUSION:: Clinically insignificant differences were found in peripheral angles between keratoconus and healthy eyes, giving support to the use of large diameter, intralimbal contact lenses with peripheral designs, and resting on the same corneal region, as those fitted on normal corneas.Preprin

Changes in Group A Streptococcus emm Types Associated with Invasive Infections in Adults, Spain, 2023

An increase in invasive group A Streptococcus infection was detected in the northeast of Spain in November 2022. A postpandemic decline in the diversity of circulating emm types involved in invasive group A Streptococcus was observed, along with the emergence of emm49 in this geographic area.S

Anterior chamber parameters in early and advanced keratoconus. A meridian by meridian analysis

Purpose: To explore anterior segment changes with keratoconus onset and progression to determine whether structural changes are predominantly corneal, limbal or both. To investigate these changes in different corneal meridians. Method: Eighty-four eyes with keratoconus and 49 healthy eyes were included in the study. Eyes with keratoconus were divided in two groups according to the Amsler-Krumeich classification: stage I and stages II-IV. Scheimpflug images at three different meridians were used to evaluate the following parameters: anterior chamber depth from the endothelium (ACD_end) and corneal thickness (CT) (software provided), anterior chamber depth (ACD) and sagittal depth (SAGT) from the epithelium, and distance from the end point of SAGT to the anterior surface of the lens (DL) (measured manually), and [ACD – CT] and [SAGT – CT] (calculated). Changes in these parameters with ocular condition and meridian were analysed. Results: Statistically significant larger values were found of ACD (p=0.012) and DL (p=0.016) with keratoconus onset and progression, with no differences in SAGT values. Besides, [ACD – CT] and [SAGT – CT] were significantly larger in keratoconus eyes (p<0.001 and p=0.003, respectively). Significant differences (all p<0.001) were found in SAGT, [SAGT – CT] and DL among meridians. Changes in these parameters with keratoconus onset and progression were similar in all meridians. Conclusion: Considering the results from the three meridians under investigation, it may be concluded that keratoconus onset has an impact on the anterior segment as a whole and not only on corneal structures. The DL distance is a useful parameter to describe limbal changes in keratoconus

Comparative analysis of peripheral corneal geometry in health and Keratoconus

OBJECTIVES:: To describe and compare corneal peripheral angles in normal and keratoconic eyes, to gain a better understanding of the topography of the periphery of the cornea in keratoconus and assist practitioners in the selection and fitting of large diameter contact lenses. METHODS:: Eighty-eight eyes were included in the study, divided into three groups: healthy (A0, 28 eyes), keratoconus at stage I according to the Amsler-Krumeich classification (AI, 33 eyes) and keratoconus at stages II to IV (AII, 27 eyes). The Pentacam Scheimpflug system was used to manually measure the corneal peripheral angles corresponding to a chord length range between 8.6 and 12.6 mm at 8 different peripheral locations. RESULTS:: The peripheral angle was influenced by ocular condition and by the peripheral location, with no interaction effect between both factors. Statistically significant differences were found in mean corneal peripheral angles between groups A0 (30.84°±2.33°) and AI (31.63°±2.02°) (P=0.001) and between A0 and AII (31.37°±2.11°) (P=0.030). The differences between AI and AII were not significant. In all eyes, the largest and smallest peripheral angles were found at the temporal inferior and temporal superior locations, respectively, with a mean difference between largest and smallest of 3.37°±1.42° in healthy eyes and 2.96°±1.54° in keratoconus (AI+AII). CONCLUSION:: Clinically insignificant differences were found in peripheral angles between keratoconus and healthy eyes, giving support to the use of large diameter, intralimbal contact lenses with peripheral designs, and resting on the same corneal region, as those fitted on normal corneas