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Videokeratographic anomalies in familial keratoconus
David Levy1, Helen Hutchings, Jean F Rouland
1Service Ophtalmologie, Hôpital Purpan, Toulouse, France.
Objective:
To analyze videokeratography of relatives of established familial keratoconus (FK) patients to detect low-expressivity keratoconus and improve the diagnosis criteria of forme fruste keratoconus.
Design:
Multicenter case-control study.
Participants:
Twenty-three families with 55 clinical keratoconus patients, 89 first-degree relatives, 43 other relatives, and a control group of 130 subjects.
Methods:
Videokeratography was performed on both eyes of patients after clinical examination, and corneal maps were analyzed. Statistical comparisons were conducted between first-degree and other relatives and a control population.
Main Outcome Measures:
Qualitative (using a 0.5-diopter [D] increment scale) and quantitative analyses of videokeratographs.
Results:
Two corneal patterns were overrepresented in the relatives of FK patients: the J and inverted-J form patterns. Results of the quantitative analysis of these suspect patterns showed that the inferior - superior values (reflecting the inferior - superior dioptric asymmetry) were close to 0.8 D and the Srax (relative skewing of the steepest radial axes) was superior to 21 degrees.
Conclusion:
Our study using topography in clearly established genetic keratoconus families allowed us to detect suspect topographical patterns and brings new data to the difficult task of diagnosing forme fruste keratoconus.