Keratoconus: The ABCD Grading System

Klinische Monatsblätter für Augenheilkunde
M W Belin, J K Duncan

Abstract

To propose a new keratoconus classification/staging system that utilises current tomographic data and better reflects the anatomical and functional changes seen in keratoconus. A previously published normative database was reanalysed to generate both anterior and posterior average radii of curvature (ARC and PRC) taken from a 3.0 mm optical zone centred on the thinnest point of the cornea. Mean and standard deviations were recorded and anterior data were compared to the existing Amsler-Krumeich (AK) Classification. ARC, PRC, thinnest pachymetry and distance visual acuity were then used to construct a keratoconus classification. 672 eyes of 336 patients were analysed. Anterior and posterior values were 7.65 ± 0.236 mm and 6.26 ± 0.214 mm, respectively, and thinnest pachymetry values were 534.2 ± 30.36 µm. The ARC values were 2.63, 5.47 and 6.44 standard deviations from the mean values of stages 1-3 in the AK classification, respectively. PRC staging uses the same standard deviation gates. The pachymetric values differed by 4.42 and 7.72 standard deviations for stages 2 and 3, respectively. A new keratoconus staging incorporates anterior and posterior curvature, thinnest pachymetric values, and distance visual acuity and consists...Continue Reading

Citations

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