Ectatic Corneal Disease Commonly Identified by Asymmetric Topographical Patterns

Corneal topography examination
Corneal topography examination, Model. (Photo by: BSIP/Universal Images Group via Getty Images)
Investigators examine the prevalence of a variety of topographical patterns noted among patients with ectatic corneal disease.

Asymmetric and central or paracentral topographical patterns are the most common observed among patients with ectatic corneal disease (ECD), according to research published in Optometry and Vision Science. 

Researchers conducted a retrospective, cross-sectional analysis of 632 consecutive patients with ECD (mean age, 23.6±8.2 years; 59.3% men) presenting to a single center. The participants underwent comprehensive eye exams that included Scheimpflug imaging and topographical pattern assessment using a sagittal map. A total of 18 different patterns were classified and placed into 1 of 5 groups which included central or paracentral, asymmetric, peripheral, advanced, and rare patterns. The primary outcome was to identify the prevalence of these patterns. 

According to the report, asymmetric patterns were the most common (39.6%; 95% CI, 35.7-43.5%). Among patients with asymmetric patterns, asymmetric bowtie (AB) with steepest radial axis index (SRAX) (18.8%) and AB with inferior steep (16.0%) were most common. Central or paracentral patterns were the second most commonly observed patterns (28.6%; 95% CI, 25.1-32.3%) with inferior steep (12.2%), heart (7.4%), and oval (4.1%) most commonly noted among these patients. Advanced, peripheral, and rare patterns accounted for 17.3%, 11.7%, and 2.8% of images, respectively. 

“[E]ctatic corneal diseases can present with a wide variety of patterns on topography,” according to the researchers. “Asymmetric and central or paracentral are the most common patterns in our study. The higher prevalence of advanced patterns at the time of first presentation indicates the need for earlier diagnosis of ectatic corneal diseases in our population.”

Study limitations include a retrospective nature and single center design. 


Shah Z, Singh S, Shilpy N, Purohit D. Prevalence of corneal topographic patterns in ectatic corneal diseases. Optom Vis Sci. 2022;99(7):560-567. doi:10.1097/OPX.0000000000001908