Pellucid marginal degeneration classification development based on investigation of relationship between functional and refractive changes

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Abstract

BACKGROUND: One of the problems in the diagnosis and treatment of pellucid marginal degeneration of the cornea is the difficulty of systematizing its manifestations due to the lack of classification. This is due to the low frequency of pellucid marginal degeneration in the structure of primary keratectasia, the main type of which is keratoconus. The developed classifications of keratoconus cannot be fully applied to pellucid marginal degeneration.

AIM: The aim was to develop a classification of pellucid marginal degeneration based on investigation of relationship between functional and refractive changes.

MATERIALS AND METHODS: The study included 42 people (42 eyes) with pellucid marginal degeneration. Keratometry and refractometry were performed, uncorrected and best corrected visual acuity, as well as cylindrical and spherical components of subjective refraction were studied, and retinal visual acuity was determined. The 1st group – 12 patients (12 eyes) with fully corrected induced ametropia (best corrected visual acuity ≥0.8), the 2nd group – 17 patients (17 eyes) with partially corrected induced ametropia (<0.8 and ≥0.3), the 3rd group – 13 patients (13 eyes) with uncorrected induced ametropia (<0.3).

RESULTS: To develop a clinical classification of pellucid marginal degeneration by stages, we selected: the values of corneal astigmatism, best corrected visual acuity and Index of difference between the values of maximum and minimum keratometry (ΔK), all of which had good separation of obtained data, and their demarcate values in groups.

CONCLUSION: The study showed the presence of relationship between functional and refractive changes indices of eyes with pellucid marginal degeneration. The leading parameters of refractive status, objectively determining the value of best corrected visual acuity, are induced corneal astigmatism and ΔK. The developed classification of pellucid marginal degeneration is easy to use and makes it possible to determine the stage of keratectasia even if there is only induced corneal astigmatism or ΔK values.

About the authors

Irina V. Vasilieva

S.N. Fedorov Eye Microsurgery Federal State Institution

Author for correspondence.
Email: naukakhvmntk@mail.ru
ORCID iD: 0000-0002-8226-1292
SPIN-code: 5921-0214
ResearcherId: AAK-8884-2021

Ophthalmologist of Highest Qualification

Russian Federation, 211, Tikhookeanskaya st., Khabarovsk, 680033

Sergey V. Kostenev

S.N. Fedorov Eye Microsurgery Federal State Institution

Email: naukakhvmntk@mail.ru
ORCID iD: 0000-0002-7387-7669
SPIN-code: 1813-0938
Scopus Author ID: 56034394400
ResearcherId: F-9091-2017

Dr. Sci. (Med.), Senior Researcher Director

Russian Federation, Moscow

Alexey V. Vasiliev

S.N. Fedorov Eye Microsurgery Federal State Institution

Email: naukakhvmntk@mail.ru
ORCID iD: 0000-0001-9712-0276
SPIN-code: 5780-0798
ResearcherId: AAK-7971-2021

Cand. Sci. (Med.), MD, Ophtalmologist of Highest Qualification, Chief of Cataract Surgery Department

Russian Federation, 211, Tikhookeanskaya st., Khabarovsk, 680033

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Supplementary files

Supplementary Files
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1. JATS XML
2. Fig. 1. Pentacam Map Report. Keratotopographic pattern and keratopachymetric map of a patient with pellucid marginal degeneration of the cornea

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3. Fig. 2. Uncorrected visual acuity (UCVA) in patients with pellucid marginal degeneration of the cornea

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4. Fig. 3. Best corrected visual acuity (BCVA) values in patients with pellucid marginal degeneration of the cornea

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5. Fig. 4. Induced corneal astigmatism in patients with pellucid marginal degeneration of the cornea

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6. Fig. 5. Cylindrical component of subjective refraction value in patients with pellucid marginal degeneration of the cornea

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7. Fig. 6. Spherical component of subjective refraction value in patients with pellucid marginal degeneration of the cornea

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8. Fig. 7. Cylindrical component of objective refraction in patients with pellucid marginal degeneration of the cornea

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9. Fig. 8. Spherical component of objective refraction in patients with pellucid marginal degeneration of the cornea

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10. Fig. 9. Maximum keratometry values (Kmax) in patients with pellucid marginal degeneration of the cornea

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11. Fig. 10. Minimum keratometry values (Kmin) in patients with pellucid marginal degeneration of the cornea

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12. Fig. 11. Difference between values of maximum and minimum keratometry values (ΔK) in patients with pellucid marginal degeneration of the cornea

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13. Fig. 12. Minimum keratopachymetry values (КПМmin) in patients with pellucid marginal degeneration of the cornea

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Copyright (c) 2021 Vasilieva I.V., Kostenev S.V., Vasiliev A.V.

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This work is licensed under a Creative Commons Attribution 4.0 International License.
 


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