Materiały źródłowe

• #1 Keratoconus: Symptoms, Causes & Treatment

  https://my.clevelandclinic.org/health/diseases/14415-keratoconus

  With treatment, the outlook for someone with keratoconus is good. […] Every person is different. Some people have mild cases of keratoconus that dont progress. Other people have cases that do progress. No one can predict what will happen in every case. […] Untreated keratoconus can lead to permanent vision loss. The changes to the cornea make it difficult for your eye to focus with or without eyeglasses or standard soft contact lenses.

• #1 Keratoconus – Wikipedia

  https://en.wikipedia.org/wiki/Keratoconus

  Patients with keratoconus typically present initially with mild astigmatism and myopia, commonly at the onset of puberty, and are diagnosed by the late teenage years or early 20s. […] A diagnosis of the disease at an early age may indicate a greater risk of severity in later life. […] The course of the disorder can be quite variable, with some patients remaining stable for years or indefinitely, while others progress rapidly or experience occasional exacerbations over a long and otherwise steady course. Most commonly, keratoconus progresses for a period of 10 to 20 years before the course of the disease generally ceases in the third and fourth decades of life. […] In advanced cases, bulging of the cornea can result in a localized rupture of Descemet’s membrane, an inner layer of the cornea. […] Although disconcerting to the patient, the effect is normally temporary and after a period of six to eight weeks, the cornea usually returns to its former transparency. […] The recovery can be aided nonsurgically by bandaging with an osmotic saline solution.

• #1

  https://journals.lww.com/ijo/fulltext/2024/72040/current_concepts_in_the_management_of_cataract.11.aspx

  However, certain eyes with KCN do progress, the natural mechanism of which is not yet determined but could be linked to the pursued eye rubbing. […] Successful cataract surgery depends on the careful management of inflammation and modifiable risk factors such as eye rubbing, which can impact prognosis and outcomes. […] The management of cataracts in patients with KCN requires extensive preoperative intraoperative and postoperative planning to achieve optimal visual outcomes.

• #1 Natural history and predictors for progression in pediatric keratoconus | Scientific Reports

  https://www.nature.com/articles/s41598-023-32176-5

  We studied the demographic and clinical predictors associated with keratoconus progression in a pediatric population. […] The general Kaplan-Meyer curves showed no differences between RE/LE or BE/WE. […] Steepest corneas are predictors of faster progression. Allergy is also a predictor of keratoconus progression in RE. […] The present work reveals that the major factors associated with progression were: Kmax55 D (for LE, BE, and WE), and presence of allergy (for RE). […] Our data reinforce that the steepest corneas are associated with faster progression and therefore need close follow-up. The presence of allergy is also a predictor of keratoconus progression.

• #1 Predicting Keratoconus Progression and Need for Corneal Crosslinking Using Deep Learning

  https://www.mdpi.com/2077-0383/10/4/844

  We aimed to predict keratoconus progression and the need for corneal crosslinking (CXL) using deep learning (DL). […] The primary purpose of CXL is to halt the progression of keratoconus. […] However, there are no definitive criteria for predicting keratoconus progression at present. […] Therefore, a method for predicting the progression and the need for CXL in keratoconus cases at the first examination is required. […] In the present work, we aimed to determine the need for CXL to halt keratoconus progression using DL. […] The predictive performance of keratoconus progression is shown in Table 2 and Figure 4. […] When the possibility for keratoconus progression was combined with patients’ age, the AUC values were 0.783 (0.721–0.845) with the axial map, 0.784 (0.722–0.846) with the corneal pachymetry map, and 0.814 (0.755–0.872) using both maps. […] We attempted to predict the exacerbation of keratoconus that required CXL aftertime using DL and showed that the axial map or the pachymetry map combined with the patients’ age were useful indicators of the need for CXL, with about 80% probability.

• #1 Keratoconus and Possible Treatments | CollaborativeEYE

  https://collaborativeeye.com/articles/2018-jan-feb/keratoconus-and-possible-treatments/

  The prognosis is good if the condition is treated in a timely manner. […] The prognosis for keratoconus, if treated, is excellent.

• #1 Keratoconus – Sjónlag

  https://en.sjonlag.is/EyeCare/Keratoconus/

  Although it is difficult to predict how fast or how much the disease will develop per individual, the disease does not lead to total blindness. […] In the worst cases, the sight may be very bad. With today’s therapies, most people to maintain a normal life. […] Most of the time, vision and daily life is only disrupted while people are changing or getting used to lenses, or waiting for the vision to stabilize after corneal transplantation.

• #1 Predicting factors for the efficacy of cross-linking for keratoconus – PubMed

  https://pubmed.ncbi.nlm.nih.gov/35113959/

  Purpose: To evaluate predictors for success in corneal crosslinking (CXL) for keratoconus in a large cohort and extended follow-up. […] Conclusion: CXL for keratoconus is a highly effective treatment, as evident by its effects on the outcome measures: Delta Kmax and Delta LogMAR. CXL was more successful in eyes with high Kmaxpre, high SEpre, and high LogMARpre, which express disease severity. The non-accelerated epithelium-off protocol was associated with greater flattening of corneal curvature but did not show a better effect on visual acuity as compared to the other CXL protocols.

• #1 Predicting factors for the efficacy of cross-linking for keratoconus | PLOS One

  https://journals.plos.org/plosone/article?id=10.1371/journal.pone.0263528

  We also demonstrated that an improvement of visual function post-CXL was significantly affected by a higher LogMARpre, a higher SEpre, and a lower MeanKpre. […] Overall, these results show that in patients with more advanced disease, CXL might have a more potent effect. […] In univariate and multivariate analysis, non-accelerated CXL was correlated with significantly more negative Delta Kmax compared to accelerated CXL. […] In univariate and multivariate analysis, higher Kmaxpre was correlated with significantly more negative Delta Kmax. […] Higher baseline spherical equivalent (SE) correlated with greater improvement of Kmax in univariate analysis and visual acuity in multivariate analysis.

• #1 Predictive factors of the accelerated transepithelial corneal cross-linking outcomes in keratoconus | BMC Ophthalmology | Full Text

  https://bmcophthalmol.biomedcentral.com/articles/10.1186/s12886-021-02235-4

  This study aimed to evaluate the clinical outcomes and assess preoperative characteristics that may predict outcomes in keratoconus 1 year after accelerated transepithelial corneal cross-linking (ATE-CXL). […] ATE-CXL is a safe and effective treatment for keratoconus patients. Patients with thinner CCT and higher Kmax values are more likely to benefit from ATE-CXL. […] It was found that the preoperative values of CCT and Kmax were predictors determining progression postoperatively. […] Our study suggests that ATE-CXL is a safe and effective treatment for patients with keratoconus. Patients with thinner CCT and higher Kmax values were most likely to improve after ATE-CXL, but the long-term effects are yet to be elucidated and need further observation.

• #1 Impact of keratoconus stage on outcome after corneal crosslinking | BMC Ophthalmology | Full Text

  https://bmcophthalmol.biomedcentral.com/articles/10.1186/s12886-022-02425-8

  This study aimed to analyze if the outcome after corneal crosslinking (CXL) in progressive keratoconus patients depends on the stage at which the procedure is performed. This knowledge would help to improve success of CXL and to define surgery indications in those patients. […] BCVA showed a significantly higher improvement after CXL in the early stage of keratoconus compared to a higher stage. However, the postinterventional tomographic values did not differ significantly between the different modified Krumeich stages. The significantly higher improvement in BCVA after CXL in the early stage might indicate that earlier intervention provides a higher subjective benefit to the individual. […] Our data suggest that patients benefit from corneal CXL regardless of modified Krumeich stages. However, we observed trends towards a comparatively higher improvement in visual acuity in the group with the early keratoconus stage. Larger controlled studies over longer observation periods should be conducted to verify these observations. These findings may optimize the management and indication of corneal CXL in keratoconus patients.

• #1

  https://journals.lww.com/ijo/fulltext/2024/72040/current_concepts_in_the_management_of_cataract.11.aspx

  Keratoconus (KCN) is a non-inflammatory corneal condition with onset commonly in early adulthood, which gradually progresses and often stabilizes later in life. […] People with KCN are known to develop a cataract earlier than people without. […] A visually significant cataract in a KCN patient can pose a challenge. […] Choosing an appropriate IOL and precise calculation of the IOL power in eyes with variable and inconsistent keratometry (K) and axial length (AL) readings are the main challenges. […] Therefore, a tailored rather than a one-size-fits-all approach might be more suited in these cases. […] Late-onset progression of KCN is an important entity that must be kept in mind while planning cataract surgery in these people, despite the traditional teaching that regardless of treatment, its progression is limited or does not progress after the age of 30 years due to naturally occurring cross-links in the cornea.

• #1 Predictability of Intraocular Lens Power Calculation for Cataract with Keratoconus: A Multicenter Study | Scientific Reports

  https://www.nature.com/articles/s41598-018-20040-w

  This study was aimed to assess the predictability of intraocular lens (IOL) power calculation after cataract surgery for keratoconus. […] The achieved refraction was significantly more hyperopic than the targeted refraction, when keratometric readings were used (p=0.001). […] We found a significant correlation between the prediction error and the mean keratometry (Pearson correlation coefficient r=0.545, p0.001). […] Phacoemulsification with IOL implantation appeared to be safe and effective, and the accuracy was also good in mild keratoconus, but not in severe keratoconus. […] It should be noted that that a large amount of hyperopic shift occurred especially in advanced keratoconic patients, when keratometric readings were used for IOL power calculation, and that a slight, but significant, myopic shift occurred, when total corneal refractive power was used.

• #1 Predictability of Intraocular Lens Power Calculation for Cataract with Keratoconus: A Multicenter Study | Scientific Reports

  https://www.nature.com/articles/s41598-018-20040-w

  Our multicenter study showed that phacoemulsification with IOL implantation was good in measures of safety and efficacy in cataractous patients with keratoconus, and that the predictability was also good in mild keratoconus, but not in moderate to severe keratoconus. […] We should be aware that a large amount of hyperopic shift occurred in advanced keratoconus patients, when the keratometric readings were used for the IOL power calculation, and that a slight, but significant, myopic shift occurred, when total corneal refractive power was used. […] We believe that this information is helpful for determining the accurate IOL power in keratoconus in daily practice.

• #1 IOL Power Calculation in Keratoconus | SpringerLink

  https://link.springer.com/chapter/10.1007/978-3-031-50666-6_66

  Keratoconus is a progressive disorder characterised by central or paracentral corneal thinning and ectasia. The changes in the keratoconic cornea affect multiple aspects of IOL power calculation and keratoconus remains one of the last major challenges existing in IOL power calculation. […] The significant barriers to accuracy in keratoconus patients, poor understanding on how to conduct IOL power studies, and small patient sample sizes have limited the refractive outcomes in keratoconus patients. […] Keratoconus leads to a hyperopic prediction error which has been well established in studies by Watson et al. […] The first paper in keratoconus patients to follow the correct guidelines on IOL power calculation studies was done by Savini et al. in JCRS. […] The study demonstrated that the amount of hyperopic error worsened with the stage of keratoconus (+0.44 D in stage 1 up to +3.01 D in stage 3 for the SRK/T formula) and that the accuracy of IOL power calculation worsened with an increasing stage of keratoconus.

• #1 IOL Power Calculation in Keratoconus | SpringerLink

  https://link.springer.com/chapter/10.1007/978-3-031-50666-6_66

  The Kane keratoconus formula should be used in keratoconus patients with either the Barrett or SRK/T formulas being the next most accurate. There is currently not enough available evidence to recommend the Barrett True-K formula for keratoconus. The management of patient expectation should be central to the informed consent of these patients and reasonable figures to discuss with patients (when using the Kane keratoconus formula) are: 60% within 0.50 D if the average keratometry is 48 dioptres; 40% if the average keratometry is 48-53; and 25% if the average keratometry is 53 D.

• #1 Keratoconus: Practice Essentials, Background, Pathophysiology

  https://emedicine.medscape.com/article/1194693-overview

  Most patients with keratoconus do well with rigid contact and scleral lens care. […] About 10%-20% of patients with keratoconus eventually require corneal transplantation, but this number is believed to increase if good contact lens care is unavailable and decrease with early CXL treatment. […] Data suggest that this disease, although progressive, stabilizes after some time in most patients.

• #1 Prognostic factors for the progression of keratoconus – PubMed

  https://pubmed.ncbi.nlm.nih.gov/8127564/

  Purpose: The progression of keratoconus to a stage where penetrating keratoplasty (PK) is required for visual rehabilitation has considerable implications for affected patients. To assist with counselling, the authors have attempted to identify which factors measurable early in the course of the disease may indicate the likelihood of subsequent surgery. […] Several clinical variables can be measured in patients at the presentation of keratoconus that influence the probability of a subsequent PK.

• #1

  https://link.springer.com/article/10.1007/s10462-024-11016-6

  The proposed system is not only designed for accuracy but also for clinical efficiency. […] The proposed multi-source detection system based on transformers represents a significant advancement in the field of keratoconus management and addresses the limitations of existing diagnostic techniques, which often rely on single-source data and subjective assessments, by offering a comprehensive and objective framework for early detection and management of keratoconus. […] The transformer-based model outperforms traditional machine learning methods, such as SVM, Random Forests, and CNNs, in terms of accuracy, precision, recall, and F-score, while maintaining lower execution times, making it a highly efficient and effective tool for clinical settings.

• #2

  https://link.springer.com/article/10.1007/s10462-024-11016-6

  Keratoconus is a progressive eye disease characterized by the thinning and conical distortion of the cornea, leading to visual impairment. Early and accurate detection is essential for effective management and treatment. […] The early and accurate detection of keratoconus progression is critical to preventing vision loss and treating the disease effectively. […] Given the limitations of these existing methods in handling diverse data sources, and detecting and monitoring early-stage keratoconus, there is a pressing need for a more comprehensive and objective approach. […] This innovative methodology holds the potential to revolutionize keratoconus management by enabling earlier and more precise interventions, ultimately enhancing patient outcomes. […] Our work leverages the high sensitivity of transformers to model complex dependencies across multimodal datasets, allowing for more accurate early detection and differentiation between normal, suspected, and definite keratoconus cases.

• #2 Keratoconus: Practice Essentials, Background, Pathophysiology

  https://emedicine.medscape.com/article/1194693-overview

  Most patients with keratoconus do well with rigid contact and scleral lens care. […] About 10%-20% of patients with keratoconus eventually require corneal transplantation, but this number is believed to increase if good contact lens care is unavailable and decrease with early CXL treatment. […] Data suggest that this disease, although progressive, stabilizes after some time in most patients.

• #2 Natural history and predictors for progression in pediatric keratoconus | Scientific Reports

  https://www.nature.com/articles/s41598-023-32176-5

  We studied the demographic and clinical predictors associated with keratoconus progression in a pediatric population. […] The general Kaplan-Meyer curves showed no differences between RE/LE or BE/WE. […] Steepest corneas are predictors of faster progression. Allergy is also a predictor of keratoconus progression in RE. […] The present work reveals that the major factors associated with progression were: Kmax55 D (for LE, BE, and WE), and presence of allergy (for RE). […] Our data reinforce that the steepest corneas are associated with faster progression and therefore need close follow-up. The presence of allergy is also a predictor of keratoconus progression.

• #2

  https://journals.lww.com/ijo/fulltext/2024/72040/current_concepts_in_the_management_of_cataract.11.aspx

  However, certain eyes with KCN do progress, the natural mechanism of which is not yet determined but could be linked to the pursued eye rubbing. […] Successful cataract surgery depends on the careful management of inflammation and modifiable risk factors such as eye rubbing, which can impact prognosis and outcomes. […] The management of cataracts in patients with KCN requires extensive preoperative intraoperative and postoperative planning to achieve optimal visual outcomes.

• #2 Predicting Keratoconus Progression and Need for Corneal Crosslinking Using Deep Learning

  https://www.mdpi.com/2077-0383/10/4/844

  We aimed to predict keratoconus progression and the need for corneal crosslinking (CXL) using deep learning (DL). […] The primary purpose of CXL is to halt the progression of keratoconus. […] However, there are no definitive criteria for predicting keratoconus progression at present. […] Therefore, a method for predicting the progression and the need for CXL in keratoconus cases at the first examination is required. […] In the present work, we aimed to determine the need for CXL to halt keratoconus progression using DL. […] The predictive performance of keratoconus progression is shown in Table 2 and Figure 4. […] When the possibility for keratoconus progression was combined with patients’ age, the AUC values were 0.783 (0.721–0.845) with the axial map, 0.784 (0.722–0.846) with the corneal pachymetry map, and 0.814 (0.755–0.872) using both maps. […] We attempted to predict the exacerbation of keratoconus that required CXL aftertime using DL and showed that the axial map or the pachymetry map combined with the patients’ age were useful indicators of the need for CXL, with about 80% probability.

• #2 Predicting factors for the efficacy of cross-linking for keratoconus | PLOS One

  https://journals.plos.org/plosone/article?id=10.1371/journal.pone.0263528

  To evaluate predictors for success in corneal crosslinking (CXL) for keratoconus in a large cohort and extended follow-up. […] CXL for keratoconus is a highly effective treatment, as evident by its effects on the outcome measures: Delta Kmax and Delta LogMAR. […] CXL was more successful in eyes with high Kmaxpre, high SEpre, and high LogMARpre, which express disease severity. […] The non-accelerated epithelium-off protocol was associated with greater flattening of corneal curvature but did not show a better effect on visual acuity as compared to the other CXL protocols. […] Knowledge of pre-operative predictors for a successful outcome in CXL may have clinical implications for ophthalmologists when considering the indications for managing KC patients. […] In our multivariate analysis, corneal flattening effect post-CXL, was significantly affected by higher Kmaxpre, higher SEpre, higher MeanKpre, and non-accelerated CXL procedure.

• #2 Predicting factors for the efficacy of cross-linking for keratoconus | PLOS One

  https://journals.plos.org/plosone/article?id=10.1371/journal.pone.0263528

  We also demonstrated that an improvement of visual function post-CXL was significantly affected by a higher LogMARpre, a higher SEpre, and a lower MeanKpre. […] Overall, these results show that in patients with more advanced disease, CXL might have a more potent effect. […] In univariate and multivariate analysis, non-accelerated CXL was correlated with significantly more negative Delta Kmax compared to accelerated CXL. […] In univariate and multivariate analysis, higher Kmaxpre was correlated with significantly more negative Delta Kmax. […] Higher baseline spherical equivalent (SE) correlated with greater improvement of Kmax in univariate analysis and visual acuity in multivariate analysis.

• #2 Predictability of Intraocular Lens Power Calculation for Cataract with Keratoconus: A Multicenter Study | Scientific Reports

  https://www.nature.com/articles/s41598-018-20040-w

  This study was aimed to assess the predictability of intraocular lens (IOL) power calculation after cataract surgery for keratoconus. […] The achieved refraction was significantly more hyperopic than the targeted refraction, when keratometric readings were used (p=0.001). […] We found a significant correlation between the prediction error and the mean keratometry (Pearson correlation coefficient r=0.545, p0.001). […] Phacoemulsification with IOL implantation appeared to be safe and effective, and the accuracy was also good in mild keratoconus, but not in severe keratoconus. […] It should be noted that that a large amount of hyperopic shift occurred especially in advanced keratoconic patients, when keratometric readings were used for IOL power calculation, and that a slight, but significant, myopic shift occurred, when total corneal refractive power was used.

• #2 Predictability of Intraocular Lens Power Calculation for Cataract with Keratoconus: A Multicenter Study | Scientific Reports

  https://www.nature.com/articles/s41598-018-20040-w

  Our multicenter study showed that phacoemulsification with IOL implantation was good in measures of safety and efficacy in cataractous patients with keratoconus, and that the predictability was also good in mild keratoconus, but not in moderate to severe keratoconus. […] We should be aware that a large amount of hyperopic shift occurred in advanced keratoconus patients, when the keratometric readings were used for the IOL power calculation, and that a slight, but significant, myopic shift occurred, when total corneal refractive power was used. […] We believe that this information is helpful for determining the accurate IOL power in keratoconus in daily practice.

• #2 IOL Power Calculation in Keratoconus | SpringerLink

  https://link.springer.com/chapter/10.1007/978-3-031-50666-6_66

  Keratoconus is a progressive disorder characterised by central or paracentral corneal thinning and ectasia. The changes in the keratoconic cornea affect multiple aspects of IOL power calculation and keratoconus remains one of the last major challenges existing in IOL power calculation. […] The significant barriers to accuracy in keratoconus patients, poor understanding on how to conduct IOL power studies, and small patient sample sizes have limited the refractive outcomes in keratoconus patients. […] Keratoconus leads to a hyperopic prediction error which has been well established in studies by Watson et al. […] The first paper in keratoconus patients to follow the correct guidelines on IOL power calculation studies was done by Savini et al. in JCRS. […] The study demonstrated that the amount of hyperopic error worsened with the stage of keratoconus (+0.44 D in stage 1 up to +3.01 D in stage 3 for the SRK/T formula) and that the accuracy of IOL power calculation worsened with an increasing stage of keratoconus.

• #2 Keratoconus – Wikipedia

  https://en.wikipedia.org/wiki/Keratoconus

  Patients with keratoconus typically present initially with mild astigmatism and myopia, commonly at the onset of puberty, and are diagnosed by the late teenage years or early 20s. […] A diagnosis of the disease at an early age may indicate a greater risk of severity in later life. […] The course of the disorder can be quite variable, with some patients remaining stable for years or indefinitely, while others progress rapidly or experience occasional exacerbations over a long and otherwise steady course. Most commonly, keratoconus progresses for a period of 10 to 20 years before the course of the disease generally ceases in the third and fourth decades of life. […] In advanced cases, bulging of the cornea can result in a localized rupture of Descemet’s membrane, an inner layer of the cornea. […] Although disconcerting to the patient, the effect is normally temporary and after a period of six to eight weeks, the cornea usually returns to its former transparency. […] The recovery can be aided nonsurgically by bandaging with an osmotic saline solution.

• #2 Keratoconus – Sjónlag

  https://en.sjonlag.is/EyeCare/Keratoconus/

  Although it is difficult to predict how fast or how much the disease will develop per individual, the disease does not lead to total blindness. […] In the worst cases, the sight may be very bad. With today’s therapies, most people to maintain a normal life. […] Most of the time, vision and daily life is only disrupted while people are changing or getting used to lenses, or waiting for the vision to stabilize after corneal transplantation.

• #2 Keratoconus: Symptoms, Causes & Treatment

  https://my.clevelandclinic.org/health/diseases/14415-keratoconus

  With treatment, the outlook for someone with keratoconus is good. […] Every person is different. Some people have mild cases of keratoconus that dont progress. Other people have cases that do progress. No one can predict what will happen in every case. […] Untreated keratoconus can lead to permanent vision loss. The changes to the cornea make it difficult for your eye to focus with or without eyeglasses or standard soft contact lenses.

• #3

  https://journals.lww.com/ijo/fulltext/2024/72040/current_concepts_in_the_management_of_cataract.11.aspx

  Keratoconus (KCN) is a non-inflammatory corneal condition with onset commonly in early adulthood, which gradually progresses and often stabilizes later in life. […] People with KCN are known to develop a cataract earlier than people without. […] A visually significant cataract in a KCN patient can pose a challenge. […] Choosing an appropriate IOL and precise calculation of the IOL power in eyes with variable and inconsistent keratometry (K) and axial length (AL) readings are the main challenges. […] Therefore, a tailored rather than a one-size-fits-all approach might be more suited in these cases. […] Late-onset progression of KCN is an important entity that must be kept in mind while planning cataract surgery in these people, despite the traditional teaching that regardless of treatment, its progression is limited or does not progress after the age of 30 years due to naturally occurring cross-links in the cornea.

• #3

  https://link.springer.com/article/10.1007/s10462-024-11016-6

  Keratoconus is a progressive eye disease characterized by the thinning and conical distortion of the cornea, leading to visual impairment. Early and accurate detection is essential for effective management and treatment. […] The early and accurate detection of keratoconus progression is critical to preventing vision loss and treating the disease effectively. […] Given the limitations of these existing methods in handling diverse data sources, and detecting and monitoring early-stage keratoconus, there is a pressing need for a more comprehensive and objective approach. […] This innovative methodology holds the potential to revolutionize keratoconus management by enabling earlier and more precise interventions, ultimately enhancing patient outcomes. […] Our work leverages the high sensitivity of transformers to model complex dependencies across multimodal datasets, allowing for more accurate early detection and differentiation between normal, suspected, and definite keratoconus cases.

• #3 Predicting Keratoconus Progression and Need for Corneal Crosslinking Using Deep Learning

  https://www.mdpi.com/2077-0383/10/4/844

  We aimed to predict keratoconus progression and the need for corneal crosslinking (CXL) using deep learning (DL). […] The primary purpose of CXL is to halt the progression of keratoconus. […] However, there are no definitive criteria for predicting keratoconus progression at present. […] Therefore, a method for predicting the progression and the need for CXL in keratoconus cases at the first examination is required. […] In the present work, we aimed to determine the need for CXL to halt keratoconus progression using DL. […] The predictive performance of keratoconus progression is shown in Table 2 and Figure 4. […] When the possibility for keratoconus progression was combined with patients’ age, the AUC values were 0.783 (0.721–0.845) with the axial map, 0.784 (0.722–0.846) with the corneal pachymetry map, and 0.814 (0.755–0.872) using both maps. […] We attempted to predict the exacerbation of keratoconus that required CXL aftertime using DL and showed that the axial map or the pachymetry map combined with the patients’ age were useful indicators of the need for CXL, with about 80% probability.

• #3 Predicting factors for the efficacy of cross-linking for keratoconus | PLOS One

  https://journals.plos.org/plosone/article?id=10.1371/journal.pone.0263528

  To evaluate predictors for success in corneal crosslinking (CXL) for keratoconus in a large cohort and extended follow-up. […] CXL for keratoconus is a highly effective treatment, as evident by its effects on the outcome measures: Delta Kmax and Delta LogMAR. […] CXL was more successful in eyes with high Kmaxpre, high SEpre, and high LogMARpre, which express disease severity. […] The non-accelerated epithelium-off protocol was associated with greater flattening of corneal curvature but did not show a better effect on visual acuity as compared to the other CXL protocols. […] Knowledge of pre-operative predictors for a successful outcome in CXL may have clinical implications for ophthalmologists when considering the indications for managing KC patients. […] In our multivariate analysis, corneal flattening effect post-CXL, was significantly affected by higher Kmaxpre, higher SEpre, higher MeanKpre, and non-accelerated CXL procedure.

• #4 Predicting factors for the efficacy of cross-linking for keratoconus | PLOS One

  https://journals.plos.org/plosone/article?id=10.1371/journal.pone.0263528

  To evaluate predictors for success in corneal crosslinking (CXL) for keratoconus in a large cohort and extended follow-up. […] CXL for keratoconus is a highly effective treatment, as evident by its effects on the outcome measures: Delta Kmax and Delta LogMAR. […] CXL was more successful in eyes with high Kmaxpre, high SEpre, and high LogMARpre, which express disease severity. […] The non-accelerated epithelium-off protocol was associated with greater flattening of corneal curvature but did not show a better effect on visual acuity as compared to the other CXL protocols. […] Knowledge of pre-operative predictors for a successful outcome in CXL may have clinical implications for ophthalmologists when considering the indications for managing KC patients. […] In our multivariate analysis, corneal flattening effect post-CXL, was significantly affected by higher Kmaxpre, higher SEpre, higher MeanKpre, and non-accelerated CXL procedure.

• #4

  https://link.springer.com/article/10.1007/s10462-024-11016-6

  Keratoconus is a progressive eye disease characterized by the thinning and conical distortion of the cornea, leading to visual impairment. Early and accurate detection is essential for effective management and treatment. […] The early and accurate detection of keratoconus progression is critical to preventing vision loss and treating the disease effectively. […] Given the limitations of these existing methods in handling diverse data sources, and detecting and monitoring early-stage keratoconus, there is a pressing need for a more comprehensive and objective approach. […] This innovative methodology holds the potential to revolutionize keratoconus management by enabling earlier and more precise interventions, ultimately enhancing patient outcomes. […] Our work leverages the high sensitivity of transformers to model complex dependencies across multimodal datasets, allowing for more accurate early detection and differentiation between normal, suspected, and definite keratoconus cases.

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