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Korneale Densitometrie

Stellenwert in der Keratokonusdiagnostik

Corneal densitometry

Value for keratoconus diagnostics

Der Ophthalmologe volume 115, pages 737–743 (2018)Cite this article

Zusammenfassung

Hintergrund

Messungen der kornealen Densitometrie, basierend auf der Scheimpflug-Fotografie, stellen eine nichtinvasive Untersuchungsmethode dar, die quantitative Angaben bezüglich der Hornhauttransparenz in unterschiedlichen Hornhautlokalisationen und unterschiedlichen Schichten erlaubt. Wir erläutern die Grundlagen der Anwendung dieser Methode und fassen die Erkenntnisse, die durch diese Methode bei Keratokonus gewonnen wurden, zusammen.

Methoden

Eine selektive Literaturrecherche und die Auswertung eigener Daten liegen dieser Arbeit zugrunde.

Ergebnisse

Die korneale Densitometrie ist bei Keratokonuspatienten im Vergleich zur gesunden altersentsprechenden Normalpopulation erhöht. Die Werte nehmen zudem mit Fortschreiten der Erkrankung zu. Nach kornealem Crosslinking (CXL) kommt es in den ersten Monaten nach der Behandlung zur Haze-Bildung und damit zu einer Abnahme der Hornhauttransparenz. Langzeitbeobachtungen durch Analysen der kornealen Densitometriedaten haben gezeigt, dass sich die Hornhauttransparenz im Laufe der Zeit nach Behandlung im Vergleich zum Ausgangswert verbessert, sodass nach 24 bis 36 Monaten sogar Densitometriewerte gemessen werden, die vergleichbar mit der gesunden altersentsprechenden Normalpopulation sind.

Schlussfolgerung

Die Hornhauttransparenz ist bei Patienten mit Keratokonus im Vergleich zum Normalkollektiv vermindert. Nach CXL kommt es anfangs zur einer Haze-Bildung und Minderung der Hornhauttransparenz, was sich jedoch im weiteren Verlauf ohne Behandlung deutlich verbessert.

Abstract

Background

Corneal densitometry, based on the Scheimpflug principle, is a useful noninvasive tool for quantitative evaluation of the optical quality of the cornea. It enables us to evaluate corneal transparency in the different corneal layers and different annuli. In this article, we discuss the basis of application of corneal densitometry measurements and summarize findings in patients with keratoconus.

Methods

This article is based on a selective literature review and analysis of own data.

Results

Patients with keratoconus have significant higher corneal densitometry values compared to healthy controls. Densitometry values also correlate with the extent of the disease. In the first months after corneal cross-linking (CXL), haze formation occurs and leads to a decrease in corneal transparency, thus densitometry peaks. Long-term analysis of densitometric data have shown that corneal transparency then starts to decrease after 3 to 6 months, and improves further with time. At 24 to 36 months after CXL, corneal transparency levels might achieve physiological values.

Conclusion

Corneal transparency is reduced in patients with keratoconus. In the first months after CXL, haze formation and a reduction in corneal transparency can be observed, which subsequently improve with time.

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Author information

Affiliations

  1. Klinik für Augenheilkunde, Universitätsklinikum Münster, Domagkstraße15, 48149, Münster, Deutschland

    M. Alnawaiseh & N. Eter

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  1. M. Alnawaiseh
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  2. N. Eter
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Corresponding author

Correspondence to M. Alnawaiseh.

Ethics declarations

Interessenkonflikt

M. Alnawaiseh gibt an, dass kein Interessenkonflikt besteht, N. Eter: Fa. Novartis: Forschungsförderung, Vortragshonorare, Studienunterstützung für die Abteilung, Advisory Board, Fa. Bayer: Forschungsförderung, Vortragshonorare, Beraterhonorare, Advisory Board, Fa. Allergan: Forschungsförderung, Vortragshonorare, Advisory Board, Fa. Heidelberg Engineering: Vortragshonorare, Fa. Bausch & Lomb: Advisory Board, Fa. Alimera Sciences: Advisory Board, Fa. Roche: Advisory Board.

Dieser Beitrag beinhaltet keine von den Autoren durchgeführten Studien an Menschen oder Tieren.

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Alnawaiseh, M., Eter, N. Korneale Densitometrie. Ophthalmologe 115, 737–743 (2018). https://doi.org/10.1007/s00347-018-0667-3

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Schlüsselwörter

  • Korneale Densitometrie
  • Scheimpflug-Fotografie
  • Hornhauttransparenz
  • Keratokonus
  • Korneales Crosslinking

Keywords

  • Corneal densitometry
  • Scheimpflug imaging
  • Corneal transparency
  • Keratoconus
  • Corneal crosslinking