Changes of corneal tomography in patients with congenital blepharoptosis

Tiepei Zhu,Hailong Ni,Jingyi Wang,Peifang Xu,Huina Zhang,Zhaoan Su,Xin Ye,Juan Ye

doi:10.1038/s41598-017-06823-7

Tiepei Zhu, Hailong Ni + Show 6 more

Open Access

https://doi.org/10.1038/s41598-017-06823-7

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Abstract

The study aimed to evaluate the effect of drooped eyelid on corneal tomography in congenital blepharoptosis patients. Sixty-four patients with congenital blepharoptosis and 64 age- and sex- matched healthy subjects were included. According to the eyelid margin to corneal light reflex distance (MRD), eyes with congenital blepharoptosis were categorized as mild, moderate, or severe. The eyes were scanned using the rotating Scheimpflug camera. Increased topometric parameters were observed in moderate and severe blepharoptosis. Back corneal elevations at the thinnest point were significant higher for mild (P = 0.009), moderate (P < 0.001), and severe (P < 0.001) congenital blepharoptosis compared with controls. Maximum Ambrósio’s relational thickness (ART) was decreased in eyes with severe blepharoptosis (P < 0.001). Fnal D values were significantly higher in moderate (P < 0.001) and severe blepharoptosis (P < 0.001) groups than that of controls. There were significant correlations between MRD and most corneal tomographic parameters. Our findings indicated there was a trend toward subclinical keratoconus-like changes in the corneas of congenital blepharoptosis, with the increase of ptosis severity.

Highlights

Blepharoptosis is defined as abnormally drooping of the upper eyelid in the primary gaze, resulting in narrowing of the palpebral fissure and increasing the area of the eyelid in contact with the ocular surface
According to margin to corneal light reflex distance (MRD), 22 eyes from blepharoptosis cases were divided into mild group, eyes into moderate group, and eyes into severe group
Uğurbaş have demonstrated that the ptotic eyes had an increased incidence of corneal astigmatism, as well as higher corneal asymmetry and irregularity[3]

Summary

Introduction

Blepharoptosis is defined as abnormally drooping of the upper eyelid in the primary gaze, resulting in narrowing of the palpebral fissure and increasing the area of the eyelid in contact with the ocular surface. The corneal topography study only yields the measurement of the anterior corneal surface, it cannot reflect the alteration of the entire corneal architecture. The Scheimpflug photography-based system with the capability to measure both the anterior and posterior corneal surfaces utilized a rotating Scheimpflug camera, and could provide more accurate details in corneal morphologic characteristics, including corneal elevation maps, corneal thickness spatial profile, and the percentage of thickness increase[5,6,7]. To the best of our knowledge, changes of corneal tomography in congenital blepharoptosis have not been studied in detail or reported in the literature. We aim to investigate the changes in corneal curvature, elevation, as well as pachymetric parameters over a range of severity of blepharoptosis and normal corneas by using a rotating Scheimpflug corneal tomographer, with a view to contributing to our understanding of the specific corneal structural alterations in congenital blepharoptosis

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