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Subclinical keratoconus and forme fruste keratoconus: a systematic review of the existent literature about definitions and discriminative criteria

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Session Details

Session Title: Presented Poster Session: Training & Quality of Vision

Venue: Poster Village: Pod 3

First Author: : M.Henriquez PERU

Co Author(s): :    L. Izquierdo Jr   M. Hadid   C. Maldonado   J. Chauca              

Abstract Details


To identify and analyzed keratoconus terminology and discriminative criteria used in studies of subclinical keratoconus (SCK) and/or forme fruste keratoconus (FFKC).


Instituto Oftalmosalud - Research Department


: Prospective, systematic review of electronic database in PubMed, the Cochrane Library, Embase and the Chinese Biomedicine Database of all studies using the keywords “subclinical keratoconus and/or forme fruste keratoconus.” Two independent reviewers analyze the data; the Quality Index assessed the quality of the included literature. We analyzed the selected articles in the following aspects: type of the study, sample size, diagnosis criteria for SCK and FFKC, suggested discriminative parameters, cutoff values, and technology used. Statistical analysis was performed using Stata 13 software.


The initial search yielded 198 articles, from them 103 where included. From SCK studies, 4.85% were cases series, 40.77% were retrospective study, 38.83% prospective study, 21.35 % cross-sectional study. 43.68% explain the subclinical keratoconus definition used and 53.39% only refers to a reference cited the article. 82.52 % refers to a more than one variable to discriminate between normal and SCK. 29.12% included elevation data, 30.09% aberrometric data, 5.82% biomechanical data, 82.52 curvature data to distinguish between normal and SCK. The discriminative analysis reported a sensitivity and specificity range between 60-99% and 63-99% to distinguish between normal and SCK respectively.


Subclinical keratoconus refers to a cornea with one or more tomographic and/or topographic signs of keratoconus and normal-appearing cornea at slit-lamp biomicroscopy. More than 90% of the studies refer to a more than 1 parameter to discriminate between normal and subclinical keratoconus eyes rather than a single parameter.

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