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Vertical D: a novel topographic pattern in some keratoconus suspects.

Juan Carlos Abad¹, Roy S Rubinfeld, Maria Del Valle

¹Laser Eye Center of Miami, Miami, Florida, USA. jcabad@gmail.com

|February 13, 2007

Summary

A novel corneal topographic pattern, vertical D, was identified in keratoconus suspects, including those with post-LASIK ectasia. This pattern indicates horizontal asymmetry, aiding in early keratoconus detection.

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Area of Science:

Ophthalmology
Corneal topography
Keratoconus detection

Background:

Keratoconus is a progressive thinning and ectasia of the cornea.
Early detection of keratoconus is crucial to prevent vision loss, especially in refractive surgery candidates.
Standard keratoconus detection analyses may not identify all suspect cases.

Observation:

A novel corneal topographic pattern, termed vertical D, was observed.
This pattern was retrospectively identified in patients who developed post-LASIK ectasia.
Prospectively, the vertical D pattern was found in patients with other corneal abnormalities suggestive of keratoconus.

Findings:

The vertical D pattern was detected in 0.34% of refractive surgical candidates.
Eyes with the vertical D pattern exhibited significant horizontal curvature asymmetry (nasal-temporal ratio) compared to vertical asymmetry (inferior-superior ratio).
Associated findings included thin central corneal thickness and/or posterior corneal protrusion.

Implications:

The vertical D pattern represents a novel indicator of corneal asymmetry in keratoconus suspects.
This finding may improve the identification of individuals at risk for keratoconus, even with negative standard analyses.
Early identification of the vertical D pattern could guide clinical management and prevent ectasia progression.