Abstract
Purpose
The corneo-scleral-profile (CSP) describes the transition from cornea to sclera, while
the corneo-scleral junction angle (CSJ), is the angle formed between the cornea and
the sclera. The aims of this study were (i) to analyse the CSP and CSJ in different
quadrants and (ii) to test correlation and repeatability of an established observational
grading and measurement method, using Scheimpflug images.
Methods
The nasal, temporal, superior and inferior CSP of 35 healthy eye participants (mean
age 25.5 SD ± 3.1 years; 20 female) was imaged using the corneo-scleral-profile module
of the Pentacam (Oculus, Wetzlar, Germany). On the captured Scheimpflug images CSP
was subjectively graded into five different corneo-scleral transitions, using the
Meier grading scale (profile 1 fluid-convex; profile 2 fluid-tangential; profile 3
marked-convex; profile 4 marked-tangential; profile 5 concave). The CSJ was measured
on the same images using ImageJ v1.8.0. Grading and measurement was repeated at a
second session. Intra-observer reliability for the CSP-grading was analysed by Cohen’s
Kappa. Differences between repeated CSJ-measurements and different quadrants were
analysed by paired-t-test and ANOVA. The eta-coefficient was used to determine the association between
subjective CSP-grading and CSJ-measurement.
Results
Intra-observer reliability for the CSP grading system was poor (kappa = 0.098) whereas
repeated measurements of CSJ angle showed no statistically significant difference
between sessions (0.04°; 95 % CI − 0.21° to 0.29°; p = 0.77). CSJ angles ranged from
172° to 180° with no statistically significant differences between nasal, temporal,
superior and inferior (p = 0.24). Eta-coefficient indicated a weak association between
CSP-grading and CSJ-measurement (η = 0.27; p = 0.04).
Conclusions
The subjective CSP-grading showed poorer repeatability than the objective CSJ-measurement,
which did not detect any differences in angles between the meridians.
The weak association between CSP-grading and CSJ-measurement is likely caused by the
limited intra-observer reliability of the Meier grading scale. Furthermore, the CSP-grading
scale seems to consider other aspects beside the CSJ angle, such as scleral radius.
Keywords
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References
- The corneo scleral profile.NOJ. 1987; 1: 66-71
- Corneo scleral profile for individual contact lens fitting.Die Kontaktlinse. 1992; 26: 4-11
- The corneo scleral profile and its effects on the design of soft lenses.Die Kontaktlinse. 2001; 5: 26-34
- Accuracy and repeatability of grading corneo scleral profile.Die Kontaktlinse. 2007; 40: 26-28
- The influence of corneoscleral topography on soft contact lens fit.Invest Ophthalmol Vis Sci. 2011; 52: 6801-6806
- Factors affecting corneoscleral topography.Invest Ophthalmol Vis Sci. 2013; 54: 3691-3701
- Corneoscleral topography measured with Fourier-based profilometry and Scheimpflug imaging.Optom Vis Sci. 2020;
G. DeNaeyer, D.R. Sanders, sMap3D Corneo-Scleral Topographer Repeatability in Scleral Lens Patients, Eye Contact Lens 44 Suppl 1 (2018) S259-S264.
- Principles of operation, accuracy and precision of an Eye Surface Profiler.Ophthalmic Physiol Opt. 2016; 36: 266-278
- CLEAR - scleral lenses.Cont Lens Anterior Eye. 2021; 44: 270-288
- Comparative analysis of two clinical diagnostic methods of the corneoscleral geometry.Eye Contact Lens. 2021; 47: 546-551
- Scleral asymmetry as a potential predictor for scleral lens compression.Ophthalmic Physiol Opt. 2018; 38: 609-616
- An analysis of anterior scleral shape and its role in the design and fitting of scleral contact lenses.Cont Lens Anterior Eye. 2018; 41: 205-213
- Clinical significance of contact lens related changes of ocular surface tissue observed on optical coherence images.Cont Lens Anterior Eye. 2020; 101388
- The role of corneo-scleral junction in soft contact lens fitting: Case report on nanophthalmos.Cont Lens Anterior Eye. 2019; 42: 226-228
- Optical coherence tomography and scleral contact lenses: clinical and research applications.Clin Exp Optom. 2019; 102: 224-241
- The influence of limbal and scleral shape on scleral lens design.Cont Lens Anterior Eye. 2018; 41: 321-328
- Clinical grading and the effects of scaling.Invest Ophthalmol Vis Sci. 1991; 32: 422-432
- Geometrical characterization of the corneo-scleral transition in normal patients with Fourier domain optical coherence tomography.Int Ophthalmol. 2019; 39: 2603-2609
- Scleral topography analysed by optical coherence tomography.Cont Lens Anterior Eye. 2017; 40: 242-247
Article info
Publication history
Published online: August 24, 2022
Accepted:
August 16,
2022
Received in revised form:
August 15,
2022
Received:
March 28,
2022
Identification
Copyright
© 2022 British Contact Lens Association. Published by Elsevier Ltd. All rights reserved.
