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Staging of development in Terrien’s degeneration based on corneal curvatures detected by optical coherence tomography

  • Cornea
  • Published:
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Abstract

Purpose

We aimed to explore a new classification system based on the change of focal corneal curvatures and corneal thickness in Terrien’s corneal degeneration with optical coherence tomography.

Methods

This was a cross-sectional study. Ninety eyes of 59 patients with Terrien’s degeneration were examined with slit lamp biomicroscopy, Orbscan II corneal tomography and the Visante OCT system, and were staged according to Süveges’s classification.

Results

The ratio of female to male patients was 1.57:1. The ratio of bilateral to unilateral lesions was 1.27:1. The occurrence of bilateral lesion was higher in males than in females (x2 = 7.791, p = 0.005). There was no difference in the mean age between female and male patients (t = 1.859, p = 0.068), or between patients with bilateral and unilateral lesions (t = 1.797, p = 0.078).The minimum corneal thickness at the thinnest point (MinCT) and anterior curvature of the peripheral cornea were almost normal in the initial stages of disease. The anterior curvature was flattened when MinCT became less than 0.56 mm, returned to normal when MinCT was no more than 0.24 mm, and bowed forward when MinCT was no more than 0.13 mm. The posterior corneal curvatures were bowed forward from their normal curvatures in 42 of 90 eyes when MinCT was no more than 0.41 mm. These eyes’ MinCT ranged from 0 to 0.41 mm. There was a strong correlation between change of corneal curvatures and MinCT (r = −0.943, p < 0.01). A new classification of six stages based on corneal curvatures is proposed for evaluating the development of Terrien’s degeneration. Statistically, there was a moderate correlation between either the Süveges staging or the new staging and the width and circumference of corneal lesions, visual acuity, and simulated keratometric value (all r < 0.6). The correlation of MinCT with the new classification based on corneal curvatures was higher than that with Süveges’s classification (r 1 vs. r 2 , −0.943 vs. -0.801).

Conclusion

The proposed new classification based on focal corneal curvatures is closely associated with corneal thinning, is valuable for evaluating the development of Terrien’s degeneration and may enhance surgical planning.

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Acknowledgments

This study was supported in part by “Guangdong Scientific Program 2012” in China (Grant number: 2012B010300010 and 2011B0318000295) and National Institutes of Health Grant EY018184 in the United States.

Conflict of interest statement

All authors except Dr. David Huang certify that they have NO affiliations with or involvement in any organization or entity with any financial interest (such as honoraria; educational grants; participation in speakers’ bureaus; membership, employment, consultancies, stock ownership, or other equity interest; and expert testimony or patent-licensing arrangements), or non-financial interest (such as personal or professional relationships, affiliations, knowledge or beliefs) in the subject matter or materials discussed in this manuscript.

Dr. D. Huang receives a royalty from an optical coherence tomography-related patent licensed to Carl Zeiss Meditec by the Massachusetts Institute of Technology. Dr. D. Huang has a significant financial interest in Optovue, a company that may have a commercial interest in the results of this research and technology. This potential individual conflict of interest has been reviewed and managed by OHSU.

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    Authors and Affiliations

    1. Zhongshan Ophthalmic Center at SunYat-sen University, The State Key Laboratory of Ophthalmology, 54 South Xianlie Road, Guangzhou, China, 510060

      Ning Wang, Chun-xiao Wang, Xiu-fen Lian & Shi-you Zhou

    2. The Huangpu Branch of First Affiliated Hospital of Sun Yat-sen University, #76 second Zhongshan Road, Guangzhou, China, 510080

      Ning Wang

    3. Department of Ophthalmology, Nanchang University, Jiangxi, China, 330031

      Su-juan Duan

    4. Casey Eye Institute, Oregon Health & Science University, Portland, Oregon, USA

      David Huang

    Authors
    1. Ning Wang
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    2. Chun-xiao Wang
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    Corresponding author

    Correspondence to Shi-you Zhou.

    Additional information

    Ning Wang, Chun-xiao Wang, Xiu-fen Lian and Su-juan Duan contributed equally to this work.

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    Wang, N., Wang, Cx., Lian, Xf. et al. Staging of development in Terrien’s degeneration based on corneal curvatures detected by optical coherence tomography. Graefes Arch Clin Exp Ophthalmol 253, 1757–1764 (2015). https://doi.org/10.1007/s00417-015-3057-4

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    • DOI: https://doi.org/10.1007/s00417-015-3057-4

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