Anterior Scleral Thickness Profile in Keratoconus

Purpose: Considering that peripheral corneal thinning occurs in keratoconus (KC), the anterior scleral thickness (AST) profile was measured to compare thickness variations in healthy and KC eyes across several meridians. Methods: This cross-sectional case–control study comprised 111 eyes of 111 pati...

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Main Authors: Neus Burguera-Giménez, María Amparo Díez-Ajenjo, Noemí Burguera, Cristina Peris-Martínez
Format: Article
Language:English
Published: MDPI AG 2023-11-01
Series:Life
Subjects:
Online Access:https://www.mdpi.com/2075-1729/13/11/2223
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author Neus Burguera-Giménez
María Amparo Díez-Ajenjo
Noemí Burguera
Cristina Peris-Martínez
author_facet Neus Burguera-Giménez
María Amparo Díez-Ajenjo
Noemí Burguera
Cristina Peris-Martínez
author_sort Neus Burguera-Giménez
collection DOAJ
description Purpose: Considering that peripheral corneal thinning occurs in keratoconus (KC), the anterior scleral thickness (AST) profile was measured to compare thickness variations in healthy and KC eyes across several meridians. Methods: This cross-sectional case–control study comprised 111 eyes of 111 patients: 61 KC eyes and 50 age- and axial-length-matched healthy eyes. The AST was explored at three scleral eccentricities (1, 2, and 3 mm from the scleral spur) across four scleral zones (nasal, temporal, superior, and inferior) by using swept-source optical coherence tomography. The AST variations among eccentricities and scleral regions within and between groups were investigated. Results: The AST significantly varied with scleral eccentricity in healthy eyes over the temporal meridian (<i>p</i> = 0.009), whereas in KC eyes, this variation was observed over the nasal (<i>p</i> = 0.001), temporal (<i>p</i> = 0.029) and inferior (<i>p</i> = 0.006) meridians. The thinnest point in both groups was 2 mm posterior to the scleral spur (<i>p</i> < 0.001). The sclera was thickest over the inferior region (control 581 ± 52 μm, KC 577 ± 67 μm) and thinnest over the superior region (control 448 ± 48 μm, KC 468 ± 58 μm) in both populations (<i>p</i> < 0.001 for all eccentricities). The AST profiles were not significantly different between groups (<i>p</i> > 0.05). The inferior–superior thickness asymmetry was statistically different 2 mm posterior to the scleral spur between groups (<i>p</i> = 0.009), specifically with subclinical KC (<i>p</i> = 0.03). There is a trend where the asymmetry increases, although not significantly, with the KC degree (<i>p</i> > 0.05). Conclusions: KC eyes presented significant thickness variations among eccentricities over the paracentral sclera. Although AST profiles did not differ between groups, the inferior–superior asymmetry differences demonstrated scleral changes over the vertical meridian in KC that need further investigation.
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spelling doaj.art-8e5b5600f6b3444f83d3801aba9e6c9a2023-11-24T14:52:39ZengMDPI AGLife2075-17292023-11-011311222310.3390/life13112223Anterior Scleral Thickness Profile in KeratoconusNeus Burguera-Giménez0María Amparo Díez-Ajenjo1Noemí Burguera2Cristina Peris-Martínez3Anterior Segment and Cornea and External Eye Diseases Unit, Foundation Ophthalmological Medical Hospital (FOM), Av. Pío Baroja, 12, E-46015 Valencia, SpainAnterior Segment and Cornea and External Eye Diseases Unit, Foundation Ophthalmological Medical Hospital (FOM), Av. Pío Baroja, 12, E-46015 Valencia, SpainQ Vision, Ophthalmology Department, Vithas Virgen del Mar Hospital, Ctra. el Mami a Viator, Km.1, E-04120 Almería, SpainAnterior Segment and Cornea and External Eye Diseases Unit, Foundation Ophthalmological Medical Hospital (FOM), Av. Pío Baroja, 12, E-46015 Valencia, SpainPurpose: Considering that peripheral corneal thinning occurs in keratoconus (KC), the anterior scleral thickness (AST) profile was measured to compare thickness variations in healthy and KC eyes across several meridians. Methods: This cross-sectional case–control study comprised 111 eyes of 111 patients: 61 KC eyes and 50 age- and axial-length-matched healthy eyes. The AST was explored at three scleral eccentricities (1, 2, and 3 mm from the scleral spur) across four scleral zones (nasal, temporal, superior, and inferior) by using swept-source optical coherence tomography. The AST variations among eccentricities and scleral regions within and between groups were investigated. Results: The AST significantly varied with scleral eccentricity in healthy eyes over the temporal meridian (<i>p</i> = 0.009), whereas in KC eyes, this variation was observed over the nasal (<i>p</i> = 0.001), temporal (<i>p</i> = 0.029) and inferior (<i>p</i> = 0.006) meridians. The thinnest point in both groups was 2 mm posterior to the scleral spur (<i>p</i> < 0.001). The sclera was thickest over the inferior region (control 581 ± 52 μm, KC 577 ± 67 μm) and thinnest over the superior region (control 448 ± 48 μm, KC 468 ± 58 μm) in both populations (<i>p</i> < 0.001 for all eccentricities). The AST profiles were not significantly different between groups (<i>p</i> > 0.05). The inferior–superior thickness asymmetry was statistically different 2 mm posterior to the scleral spur between groups (<i>p</i> = 0.009), specifically with subclinical KC (<i>p</i> = 0.03). There is a trend where the asymmetry increases, although not significantly, with the KC degree (<i>p</i> > 0.05). Conclusions: KC eyes presented significant thickness variations among eccentricities over the paracentral sclera. Although AST profiles did not differ between groups, the inferior–superior asymmetry differences demonstrated scleral changes over the vertical meridian in KC that need further investigation.https://www.mdpi.com/2075-1729/13/11/2223anterior scleral thicknesskeratoconusinferior–superior asymmetryswept-source OCTsclera
spellingShingle Neus Burguera-Giménez
María Amparo Díez-Ajenjo
Noemí Burguera
Cristina Peris-Martínez
Anterior Scleral Thickness Profile in Keratoconus
Life
anterior scleral thickness
keratoconus
inferior–superior asymmetry
swept-source OCT
sclera
title Anterior Scleral Thickness Profile in Keratoconus
title_full Anterior Scleral Thickness Profile in Keratoconus
title_fullStr Anterior Scleral Thickness Profile in Keratoconus
title_full_unstemmed Anterior Scleral Thickness Profile in Keratoconus
title_short Anterior Scleral Thickness Profile in Keratoconus
title_sort anterior scleral thickness profile in keratoconus
topic anterior scleral thickness
keratoconus
inferior–superior asymmetry
swept-source OCT
sclera
url https://www.mdpi.com/2075-1729/13/11/2223
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AT mariaamparodiezajenjo anteriorscleralthicknessprofileinkeratoconus
AT noemiburguera anteriorscleralthicknessprofileinkeratoconus
AT cristinaperismartinez anteriorscleralthicknessprofileinkeratoconus