title: Anatomic Predictive Factors of Acute Corneal Hydrops in Keratoconus: An Optical Coherence Tomography Study.
abstract: OBJECTIVE
  To define the optical coherence tomography (OCT) corneal changes predisposing to acute corneal hydrops among patients with advanced keratoconus.
  
  
  METHODS
  Retrospective cohort study.
  
  
  METHODS
  A total of 191 advanced keratoconic eyes from 191 patients with advanced keratoconus cases were studied.
  
  
  METHODS
  Data collected from patients with advanced keratoconus cases were studied during a minimum period of 24 months of follow-up. High-resolution Fourier-domain corneal OCT (5 μm of axial resolution) and corneal topography were performed every 4 months during the follow-up. Several anatomic features at the keratoconus cone were analyzed with OCT, including epithelial and stromal thicknesses, the aspect of Bowman's layer, the presence of Vogt's striae, and stromal opacities. A comparative analysis between anatomic corneal features in eyes that developed corneal hydrops and those that did not develop this complication during the follow-up was performed.
  
  
  METHODS
  Evaluation of anatomic corneal changes at risk of developing a corneal hydrops on the basis of OCT findings.
  
  
  RESULTS
  Eleven cases of corneal hydrops (5.8%) occurred in our series during a mean follow-up of 30 months (24-36 months). All of these patients were male and younger (23.7±5.9 years) than patients with no acute keratoconus (32.7±11.3 years). Increased epithelial thickening with stromal thinning at the conus and the presence of anterior hyperreflectives at the Bowman's layer level were significantly associated with corneal hydrops, whereas the presence of corneal scarring was a preventive factor. At the healing stage, a pan-stromal scar occurs, with a significant stromal thickening and cornea flattening.
  
  
  CONCLUSIONS
  Increased epithelial thickening, stromal thinning at the keratoconus cone, anterior hyperreflectives at the Bowman's layer level, and the absence of stromal scarring are associated with a high risk of developing corneal hydrops. These aspects should be taken into account by the clinician in the evaluation of keratoconus eyes and in the planning of corneal keratoplasty.
authors.affiliation: Centre Hospitalier National d'Ophtalmologie des XV-XX, Pierre & Marie Curie University Paris 6, Paris, France.
authors.forename: Esteban
authors.initials: E
authors.lastname: Fuentes
authors.affiliation: Centre Hospitalier National d'Ophtalmologie des XV-XX, Pierre & Marie Curie University Paris 6, Paris, France. Electronic address: sanotman1@yahoo.fr.
authors.forename: Otman
authors.initials: O
authors.lastname: Sandali
authors.affiliation: Centre Hospitalier National d'Ophtalmologie des XV-XX, Pierre & Marie Curie University Paris 6, Paris, France.
authors.forename: Mohamed
authors.initials: M
authors.lastname: El Sanharawi
authors.affiliation: Centre Hospitalier National d'Ophtalmologie des XV-XX, Pierre & Marie Curie University Paris 6, Paris, France.
authors.forename: Elena
authors.initials: E
authors.lastname: Basli
authors.affiliation: Centre Hospitalier National d'Ophtalmologie des XV-XX, Pierre & Marie Curie University Paris 6, Paris, France.
authors.forename: Taous
authors.initials: T
authors.lastname: Hamiche
authors.affiliation: Centre Hospitalier National d'Ophtalmologie des XV-XX, Pierre & Marie Curie University Paris 6, Paris, France.
authors.forename: Isabelle
authors.initials: I
authors.lastname: Goemaere
authors.affiliation: Centre Hospitalier National d'Ophtalmologie des XV-XX, Pierre & Marie Curie University Paris 6, Paris, France.
authors.forename: Vincent
authors.initials: V
authors.lastname: Borderie
authors.affiliation: Centre Hospitalier National d'Ophtalmologie des XV-XX, Pierre & Marie Curie University Paris 6, Paris, France.
authors.forename: Nacim
authors.initials: N
authors.lastname: Bouheraoua
authors.affiliation: Centre Hospitalier National d'Ophtalmologie des XV-XX, Pierre & Marie Curie University Paris 6, Paris, France.
authors.forename: Laurent
authors.initials: L
authors.lastname: Laroche
mesh_terms: D000208:Acute Disease; D000293:Adolescent; D000328:Adult; D015715:Corneal Edema / Q000175:diagnosis*; D003319:Corneal Stroma / Q000473:pathology*; D019781:Corneal Topography; D019573:Epithelium, Corneal / Q000473:pathology*; D005260:Female; D005500:Follow-Up Studies; D005583:Fourier Analysis; D006801:Humans; D007640:Keratoconus / Q000145:classification / Q000175:diagnosis*; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D041623:Tomography, Optical Coherence; D055815:Young Adult