Purpose

To investigate the current patterns of diagnosis and referral in keratoconus.

Methods

A retrospective chart review was performed of patients who had recently been diagnosed with keratoconus and attended dedicated clinics at Antwerp University Hospital, Belgium and Maria Middelares General Hospital, Ghent, Belgium between June 2013 and February 2018. Exclusion criteria included longstanding keratoconus diagnosis, reduced cognitive capabilities and prior surgical procedures (corneal crosslinking, penetrating keratoplasty or any type of refractive surgery).

Results

Three-hundred and ninety-nine patients (722 eyes) were included in this study. The mean age was 24.7 ± 6.5 years and the average maximal keratometry was 51 ± 5.2 D for the better eye and 58.4 ± 9.6 D for the worse eye. Upon diagnosis, 233 eyes (32.2 %) and 51 eyes (7.1 %) had a thinnest pachymetry <450 and <400 μm, respectively. At 6-month follow-up, 58 % of patients had been fitted with specialty contact lenses. During follow-up, 199 eyes (27.6 %) underwent corneal crosslinking. One patient underwent corneal graft surgery of his worse eye due to contact lens intolerance and insufficient visual acuity.

Conclusion

Despite advances in diagnostic tools, keratoconus is often diagnosed at a relatively late stage. Earlier detection of keratoconus would increase the overall clinical benefit of corneal crosslinking. Further research into screening strategies is required to develop cost-effective screening programs.

中文翻译：

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圆锥角膜的诊断模式

目的

调查目前圆锥角膜的诊断和转诊模式。

方法

对 2013 年 6 月至 2018 年 2 月期间在比利时安特卫普大学医院和比利时根特 Maria Middelares 综合医院就诊的近期被诊断为圆锥角膜并就诊的患者进行了回顾性图表审查。 排除标准包括长期圆锥角膜诊断、认知能力下降能力和先前的外科手术（角膜交联、穿透性角膜移植术或任何类型的屈光手术）。

结果

本研究包括 399 名患者（722 只眼）。平均年龄为 24.7 ± 6.5 岁，平均最大角膜曲率测量对于较好的眼睛为 51 ± 5.2 D，对于较差的眼睛为 58.4 ± 9.6 D。诊断后，233 只眼 (32.2 %) 和 51 只眼 (7.1 %) 的最薄厚度分别<450 和 <400 μm。在 6 个月的随访中，58% 的患者佩戴了专业隐形眼镜。在随访期间，199 只眼（27.6%）接受了角膜交联。一名患者因隐形眼镜不耐受和视力不足而接受了角膜移植手术。

结论

尽管诊断工具取得了进步，但圆锥角膜通常在相对较晚的阶段被诊断出来。圆锥角膜的早期检测将增加角膜交联的整体临床益处。需要进一步研究筛选策略，以开发具有成本效益的筛选计划。