AffiliationUniversity of Arizona, Department of Ophthalmology & Visual Science
MetadataShow full item record
CitationBelin, M. W., Alizadeh, R., Torres-Netto, E. A., Hafezi, F., Ambrósio Jr, R., & Pajic, B. (2020). Determining progression in ectatic corneal disease. The Asia-Pacific Journal of Ophthalmology, 9(6), 541-548.
RightsCopyright © 2020 Asia-Pacific Academy of Ophthalmology. Published by Wolters Kluwer Health, Inc. on behalf of the Asia-Pacific Academy of Ophthalmology. This is an open access article distributed under the terms of the Creative Commons Attribution-Non Commercial-No Derivatives License 4.0 (CC BY NC-ND).
Collection InformationThis item from the UA Faculty Publications collection is made available by the University of Arizona with support from the University of Arizona Libraries. If you have questions, please contact us at firstname.lastname@example.org.
AbstractBefore the advent of modern tomographic imaging and corneal cross-linking (CXL), diagnosis and treatment of ectatic disease were limited to disease severity where changes on the anterior corneal surface lead to visual complaints. Rigid contact lenses and/or penetrating keratoplasty addressed late stage disease, as identifying early or subclinical disease was not possible, or its need appreciated. The emergence of CXL as a viable treatment to alter the natural progression of keratoconus heightened the need for improved diagnostics.Several methods have been described in the literature to evaluate and document progression in keratoconus, but there has been no consistent definition of ectasia progression. Newer imaging techniques (ie, tomography) allowed the detection of earlier ectatic disease, before visual loss and subjective complaints. The Belin ABCD classification/staging system was introduced on a Scheimpflug imaging system [Pentacam, (Oculus GmbH, Wetzlar, Germany)] to address previous shortcomings. The ABCD system utilizes 4 parameters: Anterior ("A") and posterior ("B" for Back) radius of curvature taken from a 3.0 mm optical zone centered on the thinnest point, "C" is minimal Corneal thickness, and "D" best spectacle Distance visual acuity. The first 3 parameters (A, B, C) are machine-generated objective measurements that can be used to determine progressive change.The staging system is not limited to a specific commercial entity and can be incorporated in any tomographic imaging system. The ABCD Progression Display graphically displays each parameter and shows when statistical change above measurement noise is reached. This should allow the clinician the ability to diagnose progressive disease at a much earlier stage than was previously possible, with the confidence that earlier intervention could prevent visual loss.
NoteOpen access journal
VersionFinal published version
Except where otherwise noted, this item's license is described as Copyright © 2020 Asia-Pacific Academy of Ophthalmology. Published by Wolters Kluwer Health, Inc. on behalf of the Asia-Pacific Academy of Ophthalmology. This is an open access article distributed under the terms of the Creative Commons Attribution-Non Commercial-No Derivatives License 4.0 (CC BY NC-ND).
- ABCD: A new classification for keratoconus.
- Authors: Belin MW, Kundu G, Shetty N, Gupta K, Mullick R, Thakur P
- Issue date: 2020 Dec
- Anatomical and Visual Effects of the MyoRing Implantation Measured by the ABCD Keratoconus Grading System.
- Authors: Sedaghat MR, Momeni-Moghaddam H, Belin MW, Akbarzadeh R, Sakhaee M, Armanfar F, Shahri F, Akhavan Rezayat A
- Issue date: 2020 Jan
- Evolution of Keratoconus: From Diagnosis to Therapeutics.
- Authors: Imbornoni LM, McGhee CNJ, Belin MW
- Issue date: 2018 Jun
- Longitudinal Evaluation of the Progression of Keratoconus Using a Novel Progression Display.
- Authors: Kosekahya P, Caglayan M, Koc M, Kiziltoprak H, Tekin K, Atilgan CU
- Issue date: 2019 Sep
- Collagen Cross Linking For Keratoconus
- Authors: Vohra V, Tuteja S, Chawla H
- Issue date: 2021 Jan