Table 1 Diagnostic strategies and imaging tests in ectatic corneal diseases (ECD)
From: Multimodal diagnostics for keratoconus and ectatic corneal diseases: a paradigm shift
Diagnostic strategies | The Why’s | The How’s |
|---|---|---|
Assess complaints | Recognize the patient’s needs and personal and family history | Anamnesis, visual acuity, slit-lamp exam, and comprehensive ophthalmological exam |
Screening | Detect mild forms of ECD and characterize ectasia susceptibility before refractive surgery, contemplating the impact of LVC on the cornea | Placido-disk corneal topography, Scheimpflug tomography, Layered tomography with OCT (or VHF US), and biomechanical assessments |
Diagnostic confirmation | Paradigm shift related to the management of ECD and access ectasia risk and progression | Comprehensive clinical evaluation with multimodal imaging |
Classification of the type of ECD | Characterize the thinning pattern and pathophysiology of corneal ectasia | Integrating tomographic and biomechanical data with AI, possible future role for genetics and molecular biology |
Staging | To assess the severity of the disease before visual loss | Belin´s “ABCD” (tomography) + biomechanical “E” (Homburg) for ectasia/KC staging |
Prognostic | Patient counseling with education and management of ECD concerning the disease severity | Tomographic and biomechanical parameters (i.e., SPA-1), patient age, ocular allergy, and eye rubbing habit characterize |