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A new topographic pattern for early differentiation of pellucid marginal degeneration from keratoconus

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Session Details

Session Title: Cornea
Session Date/Time: Friday 09/02/2018 | 08:30-10:00
Paper Time: 09:15
Venue: Annex A

First Author: M.Jafarinasab IRAN
Co Author(s): D. Najdi  S. Feizi              

Abstract Details


To introduce a new topographic sign which can help to early discriminate pellucid marginal degeneration (PMD) from keratoconus (KCN).


Ophthalmic Research Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran Department of Ophthalmology,Labbafinejad Hospital,Shahid Beheshti University of Medical Sciences, Tehran, Iran.


This cross-sectional study consisted of 20 patients with bilateral but asymmetric PMD; one eye had early form of disease whereas, PMD was more advanced in the fellow eye. Computerized corneal topography and dual-Scheimpflug analyzer were performed in these eyes. Topographic pattern and indices were analyzed to differentiate the early stage of PMD from KCN.


Based on the corneal topography and tomography the diagnosis of PMD was equivocal in one eye but clear in the fellow eye with the more advanced disease. We could describe a topographic pattern which was useful in discriminating early PMD in 90% of the eyes. This pattern which looked like an apple (apple sign) constantly had two portions; a flat stem and a steep core portion. The flat portion was located in the superior part of the map with an extension from 45 to 135 degrees.


The apple pattern observed in corneal topographic map, especially in sagittal and instantaneous map, is a useful sign for the early diagnosis of PMD. Changes of steep and flat areas inside the apple pattern is a good indication of disease progression. A prospective study is now underway to confirm the clinical implications of this pattern.

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