Agreement of Kisa% and Kmax2 /Tp in the Diagnosis of Keratoconus


Authors : Rajeswari K., Sachitanand Singh

Volume/Issue : Volume 4 - 2019, Issue 12 - December

Google Scholar : https://goo.gl/DF9R4u

Scribd : https://bit.ly/2G1RlIS

 Background: Keratoconus is a progressive degenerative disorder of cornea in which structural changes in the cornea cause it to become thin and conical in shape. There are no gold standard criteria for diagnosing Keratoconus. KISA% is one of the popular criteria for diagnosing Keratoconus. The new criteria were reported in the year 2015, using Kmax 2 and TP 4 to diagnose Keratoconus. The sensitivity and specificity of this Kmax2 /TP were 99.5% and 95.7% respectively.  Materials and Methods: In this retrospective study, we collected information of 418 eyes (209 Keratoconus +209 ages matched controls). The necessary data was collected from the Visante AS OCT and Zeiss atlas topography in a tertiary eye hospital, Udupi. The demographic data of the patients was drawn from the system. . Further details on visual acuity, refractive error, slit lamp findings and fundus examinations were obtained from the MRD. All parameters included in the study were taken from the last 3 year data available in the instruments. Keratoconus diagnosis had been confirmed based on clinical and topographical findings.  Results: The parameters were entered in the IBM SPSS statistics version 24 for the analysis. KISA %[( K*I- S*AST*SRAX*)*100/300] and Kmax 2 /T were calculated and values are obtained. With these values, kappa analysis was done to find the agreement between the two criteria for diagnosing Keratoconus. It is found that the r= 0.807 (p<0.001). This showed that the two criteria have good agreement for Keratoconus diagnosis. All eyes were categorized under Amsler Krumeich and CLEK’s classification systems. Interclass Correlation statistics was used to find the level of agreement between Amsler Krumeich and CLEK classification system in diagnosing Keratoconus  Conclusion: KISA% and Kmax2 /TP showed good agreement between them in diagnosing Keratoconus. Hence both criteria can be used interchangeably for the diagnosis of Keratoconus. Amsler Krumeich and CLEK classification system showed a good level of agreement for Keratoconus diagnosis.

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