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Volume 111, Issue 5, Pages 867-874 (May 2004)


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Videokeratographic anomalies in familial keratoconus

David Levy, MD1, Helen Hutchings, PhD1, Jean F Rouland, MD2, José Guell, MD, PhD3, Carole Burillon, MD4, Jean L Arné, MD1, Joseph Colin, MD5, Laurent Laroche, MD6, Michel Montard, MD7, Bernard Delbosc, MD7, Isabelle Aptel, MD8, Hervé Ginisty, PhD1, Hélène Grandjean, MD, PhD8, Francois Malecaze, MD, PhD1Corresponding Author Informationemail address

Received 5 February 2003; accepted 22 August 2003.

Abstract 

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°.

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.

1 Service Ophtalmologie, Hôpital Purpan, Toulouse, France

2 CHU Lille, Lille, France

3 Instituto de Microcirugía Ocular, Barcelona, Spain

4 CHU Lyon, Lyon, France

5 CHU Bordeaux, Bordeaux, France

6 Hôpital XV–XX, Paris, France

7 CHU Besançon, Besançon, France

8 INSERM U558, Faculté de Médecine, Toulouse, France

Corresponding Author InformationReprint requests to F. Malecaze, Service Ophtalmologie, Hôpital Purpan, Place Baylac, 31059 Toulouse cedex, France.

 Manuscript no. 230059.

Drs Levy and Hutchings contributed equally to this work.

PII: S0161-6420(03)01731-7

doi:10.1016/j.ophtha.2003.12.024


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