Scheimpflug-Derived Keratometric, Pachymetric and Pachymetric Progression Indices in the Diagnosis of Keratoconus: A Systematic Review and Meta-Analysis
Sandra Owusu,1 Ebenezer Zaabaar,1,2 Michael Agyemang Kwarteng,3,4 Samuel Ankamah,5 John Baptist Vianney Abowine,6 Samuel Kyei1,7 1Department of Optometry and Vision Science, University of Cape Coast, Cape Coast, Ghana; 2Department of Ophthalmology and Visual Sciences, The Chinese University of Hong...
| Main Authors: | , , , , , |
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| Format: | Article |
| Language: | English |
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Dove Medical Press
2023-12-01
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| Series: | Clinical Ophthalmology |
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| Online Access: | https://www.dovepress.com/scheimpflug-derived-keratometric-pachymetric-and-pachymetric-progressi-peer-reviewed-fulltext-article-OPTH |
| _version_ | 1797383104989495296 |
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| author | Owusu S Zaabaar E Kwarteng MA Ankamah S Abowine JBV Kyei S |
| author_facet | Owusu S Zaabaar E Kwarteng MA Ankamah S Abowine JBV Kyei S |
| author_sort | Owusu S |
| collection | DOAJ |
| description | Sandra Owusu,1 Ebenezer Zaabaar,1,2 Michael Agyemang Kwarteng,3,4 Samuel Ankamah,5 John Baptist Vianney Abowine,6 Samuel Kyei1,7 1Department of Optometry and Vision Science, University of Cape Coast, Cape Coast, Ghana; 2Department of Ophthalmology and Visual Sciences, The Chinese University of Hong Kong, Hong Kong; 3Department of Optometry, Bindura University of Science Education, Bindura, Zimbabwe; 4Discipline of Optometry, University of Kwazulu-Natal, Durban, South Africa; 5University of Ghana Library System, University of Ghana, Accra, Ghana; 6Dr. Rose Mompi Eye Hospital, Hohoe, Ghana; 7Biomedical and Clinical Research Center, University of Cape Coast, Cape Coast, GhanaCorrespondence: Samuel Kyei, Email skyei@ucc.edu.ghAbstract: Scheimpflug Pentacam Tomography is becoming crucial in the diagnosis and monitoring of keratoconus, as well as in pre- and post-corneal refractive care, but there are still some inconsistencies surrounding its evidence base diagnostic outcome. Therefore, this study aimed at employing meta-analysis to systematically evaluate the keratometric, pachymetric, and pachymetric progression indices used in the diagnosis of Keratoconus. The review protocol was registered with PROSPERO (Identifier: CRD4202310058) and followed the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) statement. PubMed, MEDLINE, Web of Science, and EMBASE were used for data search, followed by a quality appraisal of the included studies using the revised tool for the quality assessment of diagnostic accuracy studies (QUADAS-2). Meta-analysis was conducted using the meta (6.5.0) and metafor (4.2.0) packages in R version 4.3.0, as well as Stata. A total of 32 studies were included in the analysis. All keratometry (K) readings (flattest meridian, K1; steepest meridian, K2, maximum, Kmax) were significantly steeper in keratoconic compared to normal eyes: [MD (95% CI)], K1 [2.67 (1.81; 3.52)], K1-back [− 0.71 (− 1.03; − 0.39)], K1-front [4.06 (2.48; 5.63)], K2 [4.32 (2.89; 5.75)], K2-back [− 1.25 (− 1.68; − 0.82)], K2-front [4.82 (1.88; 7.76)], Kmax [7.57 (4.80; 10.34)], and Kmean [2.80 (1.13; 4.47)]. Additionally, corneal thickness at the center, CCT [− 61.19 (− 73.79; − 48.60)] and apex, pachy-apex [− 41.86 (− 72.64; − 11.08)] were significantly thinner in keratoconic eyes compared to normal eyes. The pooled estimates for pachymetric progression index (PPI): PPImin [0.66 (0.43; 0.90)], PPImax [1.26 (0.87; 1.64)], PPIavg [0.90 (0.68; 1.12)], and Ambrosio relational thickness (ART): ARTmax [− 242.77 (− 288.86; − 196.69)], and ARTavg [− 251.08 (− 308.76; − 195.39)] revealed significantly more rapid pachymetric progression in keratoconic eyes than in normal eyes. The Pentacam Scheimpflug-derived keratometric, pachymetric, and pachymetric progression indices are good predictors in discriminating KC from normal eyes.Keywords: corneal topography, keratometric readings, central corneal thickness, keratoconus, pachymetric progression |
| first_indexed | 2024-03-08T21:16:00Z |
| format | Article |
| id | doaj.art-1a76cd9c9c6144688816bd52a1547a9b |
| institution | Directory Open Access Journal |
| issn | 1177-5483 |
| language | English |
| last_indexed | 2024-03-08T21:16:00Z |
| publishDate | 2023-12-01 |
| publisher | Dove Medical Press |
| record_format | Article |
| series | Clinical Ophthalmology |
| spelling | doaj.art-1a76cd9c9c6144688816bd52a1547a9b2023-12-21T17:27:36ZengDove Medical PressClinical Ophthalmology1177-54832023-12-01Volume 173941396489178Scheimpflug-Derived Keratometric, Pachymetric and Pachymetric Progression Indices in the Diagnosis of Keratoconus: A Systematic Review and Meta-AnalysisOwusu SZaabaar EKwarteng MAAnkamah SAbowine JBVKyei SSandra Owusu,1 Ebenezer Zaabaar,1,2 Michael Agyemang Kwarteng,3,4 Samuel Ankamah,5 John Baptist Vianney Abowine,6 Samuel Kyei1,7 1Department of Optometry and Vision Science, University of Cape Coast, Cape Coast, Ghana; 2Department of Ophthalmology and Visual Sciences, The Chinese University of Hong Kong, Hong Kong; 3Department of Optometry, Bindura University of Science Education, Bindura, Zimbabwe; 4Discipline of Optometry, University of Kwazulu-Natal, Durban, South Africa; 5University of Ghana Library System, University of Ghana, Accra, Ghana; 6Dr. Rose Mompi Eye Hospital, Hohoe, Ghana; 7Biomedical and Clinical Research Center, University of Cape Coast, Cape Coast, GhanaCorrespondence: Samuel Kyei, Email skyei@ucc.edu.ghAbstract: Scheimpflug Pentacam Tomography is becoming crucial in the diagnosis and monitoring of keratoconus, as well as in pre- and post-corneal refractive care, but there are still some inconsistencies surrounding its evidence base diagnostic outcome. Therefore, this study aimed at employing meta-analysis to systematically evaluate the keratometric, pachymetric, and pachymetric progression indices used in the diagnosis of Keratoconus. The review protocol was registered with PROSPERO (Identifier: CRD4202310058) and followed the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) statement. PubMed, MEDLINE, Web of Science, and EMBASE were used for data search, followed by a quality appraisal of the included studies using the revised tool for the quality assessment of diagnostic accuracy studies (QUADAS-2). Meta-analysis was conducted using the meta (6.5.0) and metafor (4.2.0) packages in R version 4.3.0, as well as Stata. A total of 32 studies were included in the analysis. All keratometry (K) readings (flattest meridian, K1; steepest meridian, K2, maximum, Kmax) were significantly steeper in keratoconic compared to normal eyes: [MD (95% CI)], K1 [2.67 (1.81; 3.52)], K1-back [− 0.71 (− 1.03; − 0.39)], K1-front [4.06 (2.48; 5.63)], K2 [4.32 (2.89; 5.75)], K2-back [− 1.25 (− 1.68; − 0.82)], K2-front [4.82 (1.88; 7.76)], Kmax [7.57 (4.80; 10.34)], and Kmean [2.80 (1.13; 4.47)]. Additionally, corneal thickness at the center, CCT [− 61.19 (− 73.79; − 48.60)] and apex, pachy-apex [− 41.86 (− 72.64; − 11.08)] were significantly thinner in keratoconic eyes compared to normal eyes. The pooled estimates for pachymetric progression index (PPI): PPImin [0.66 (0.43; 0.90)], PPImax [1.26 (0.87; 1.64)], PPIavg [0.90 (0.68; 1.12)], and Ambrosio relational thickness (ART): ARTmax [− 242.77 (− 288.86; − 196.69)], and ARTavg [− 251.08 (− 308.76; − 195.39)] revealed significantly more rapid pachymetric progression in keratoconic eyes than in normal eyes. The Pentacam Scheimpflug-derived keratometric, pachymetric, and pachymetric progression indices are good predictors in discriminating KC from normal eyes.Keywords: corneal topography, keratometric readings, central corneal thickness, keratoconus, pachymetric progressionhttps://www.dovepress.com/scheimpflug-derived-keratometric-pachymetric-and-pachymetric-progressi-peer-reviewed-fulltext-article-OPTHcorneal topographykeratometric readingscentral corneal thicknesskeratoconuspachymetric progression |
| spellingShingle | Owusu S Zaabaar E Kwarteng MA Ankamah S Abowine JBV Kyei S Scheimpflug-Derived Keratometric, Pachymetric and Pachymetric Progression Indices in the Diagnosis of Keratoconus: A Systematic Review and Meta-Analysis Clinical Ophthalmology corneal topography keratometric readings central corneal thickness keratoconus pachymetric progression |
| title | Scheimpflug-Derived Keratometric, Pachymetric and Pachymetric Progression Indices in the Diagnosis of Keratoconus: A Systematic Review and Meta-Analysis |
| title_full | Scheimpflug-Derived Keratometric, Pachymetric and Pachymetric Progression Indices in the Diagnosis of Keratoconus: A Systematic Review and Meta-Analysis |
| title_fullStr | Scheimpflug-Derived Keratometric, Pachymetric and Pachymetric Progression Indices in the Diagnosis of Keratoconus: A Systematic Review and Meta-Analysis |
| title_full_unstemmed | Scheimpflug-Derived Keratometric, Pachymetric and Pachymetric Progression Indices in the Diagnosis of Keratoconus: A Systematic Review and Meta-Analysis |
| title_short | Scheimpflug-Derived Keratometric, Pachymetric and Pachymetric Progression Indices in the Diagnosis of Keratoconus: A Systematic Review and Meta-Analysis |
| title_sort | scheimpflug derived keratometric pachymetric and pachymetric progression indices in the diagnosis of keratoconus a systematic review and meta analysis |
| topic | corneal topography keratometric readings central corneal thickness keratoconus pachymetric progression |
| url | https://www.dovepress.com/scheimpflug-derived-keratometric-pachymetric-and-pachymetric-progressi-peer-reviewed-fulltext-article-OPTH |
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