Keratoconus-like topographic changes in patients with irregular inferior epithelial thickening documented by anterior segment optical coherence tomography (AS-OCT) epithelial map

Session Details

Session Title: Presented Poster Session: Refractive

Venue: Poster Village: Pod 3

First Author: : K.Aliferis SWITZERLAND

Co Author(s): :    M. Wardani   N. Voulgari   A. Petrovic   D. Tabibian   K. Hashemi   G. Kymionis        

Abstract Details

Purpose:

To present two cases of keratoconus-like topographic changes (pseudokeratoconus) due to inferior inhomogenous epithelial thickening, pointed out with AS-OCT epithelium map.

Setting:

Jules-Gonin Ophthalmic Hospital Lausanne, Switzerland

Methods:

We present on two patients evaluated in the refractive surgery consultation with Pentacam® scheimpflug rotating camera system, presenting topographical irregularities suggesting keratoconus suspicion. Slit lamp examination, best corrected visual acuity, placido topography and anterior segment optical coherence tomography epithelium map Optovue ® were conducted and analyzed from senior cornea specialist (GK) with comparative analysis of topographical findings and epithelial map results.

Results:

A 59 y.o. male presented with “asymetric Bowtie“ inferior steepening with Kmax 47.7 Dpt, minimal pachymetry 516 microns and index of heigh decentration (IHD) 0.014. AS-OCT demonstrate corresponding inferior epithelial thickening explaining the keratoconus-like topography. It’s fellow eye had been operated with stable good results in five years follow-up after photorefractive keratectomy (attempted correction -2.75 Dpt). The second case was a 49 y.o. female presented with “asymetric Bowtie/skewed radial axes“ (AB/SRAX) topography in both eyes, more importantly in the left eye (Kmax 45.9 Dpt, IHD 0.018). AS-OCT showed corresponding inferior thikening, more pronounced in the left eye, indicating pseudokeratoconus diagnosis.

Conclusions:

We presented two cases where AS-OCT epithelium map helped to elucidate suspicious keratoconus-like topographical findings indicating pseudokeratoconus diagnosis, explained by epithelial irregular inferior thickening. Thus, epithelial irregularities should be considered in case of suspicious keratoconus-like topographical findings.

Financial Disclosure:

None