OCT in Diagnosis of Irregular Corneas

Oregon Health and Science University445 enrolled

Overview

This main goal of this study is to improve the detection, classification, monitoring, and treatment of irregular corneas due to keratoconus, warpage, dry eye, scar, stromal dystrophies, and other corneal conditions. The primary goal will be achieved by using optical coherence tomography (OCT) to: 1. Develop an OCT-based system to classify and evaluate corneal-shape irregularities. 2. Develop OCT metrics for more sensitive detection of keratoconus progression. 3. Develop OCT-and-topography guided phototherapeutic keratectomy (PTK) for irregular corneas.

Study Type

OBSERVATIONAL

Enrollment

445

Conditions

Keratoconus Corneal Opacity Corneal Dystrophy

Interventions

Optical Coherence TomographyDEVICE

This device will be used to tightly classify corneal irregularities and determine eligibility of candidates from Group A into Groups B \& C.

Eligibility

Sex: ALLMin age: 14 YearsMax age: 85 YearsHealthy volunteers:

Medical Language ↔ Plain English

Inclusion Criteria: GROUP A: * Keratoconus: 1. CDVA ≥ 20/25 in the better eye; and both of the following in the worse eye 2. Topography characteristic of keratoconus or pellucid marginal degeneration * Contact lens-related corneal warpage: 1. Contact lens use; and 2. Topography irregularities * Dry eye: 1. Symptoms of dry eye documented by Ocular Surface Disease Index (OSDI) questionnaire score ≥ 30; and 2. Topography irregularities 3. Presence of punctate epithelial erosion on exam with surface staining 4. Aqueous deficiency or evaporative dry eye * Epithelial basement membrane dystrophy (EBMD): 1. Negative corneal fluorescein staining; and 2. Corneal opacities; and 3. Topography irregularities * Stromal addition or subtraction: 1. Scars; or 2. Salzmann's degeneration; or 3. Stromal dystrophies; or 4. Complication (visual complaints) after LASIK or photorefractive keratectomy (PRK) * Stromal distortion: 1. Radial keratectomy (RK); or 2. Corneal transplants. * Normal controls: 1. Healthy eyes with no previous eye procedures/surgeries. GROUP B: Participants will be selected from the keratoconus population in Group A based on topography findings. GROUP C: Participants will be selected from the stromal addition/subtraction and stromal distortion populations of Group A if they have vision primarily limited by scars, dystrophy, or high astigmatism that could benefit from PTK. Exclusion Criteria (all groups): * Inability to give informed consent. * Inability to maintain fixation for OCT imaging. * Inability to commit to required study visits. * Eyes with concurrent cataract, retinal disease, glaucoma, or other eye conditions that may limit the visual outcome after surgery. * Previous corneal surgeries if considered as a keratoconus participant. * Pregnancy or breastfeeding.

Outcomes

Primary Outcomes

Develop OCT-based system to classify and evaluate corneal-shape irregularities

Clinical classification of keratoconus, epithelial deformation, stromal addition/subtraction, stromal distortion, and healthy controls by OCT. Primary measurements will be corneal and epithelial thicknesses assessed in micron units.

Time frame: 1 day

Develop OCT-based system to classify and evaluate corneal-shape irregularities

Secondary measurement will be OCT corneal shape assessed in Diopter units.

Time frame: 1 day

Develop OCT metrics for more sensitive detection of keratoconus progression

Primary measurements will be OCT corneal and epithelial thicknesses assessed in micron units.

Time frame: 4 year

Develop OCT metrics for more sensitive detection of keratoconus progression

Secondary measurement will be OCT corneal shape assessed in Diopter units.

Time frame: 4 year

Develop OCT- and topography-guided phototherapeutic keratectomy (PTK) for irregular corneas

The primary goal is to improve the post-procedural outcome of uncorrected and best corrected visual acuity. This will be measured in feet by conventional Snellen fraction of 20/xx.

Time frame: 1 year