■圆锥角膜(KCN)的特征是角膜逐渐变薄和陡峭化,这可能会导致严重的视力问题,由于高散光,角膜疤痕,甚至角膜穿孔。早期检测KCN对于有效治疗至关重要。在这次审查中,我们描述了KCN的诊断和治疗的最新进展。
■这篇叙述性综述集中在KCN的诊断和治疗方面的最新进展,特别是不断发展的方法和策略。为了确保包含最新文献,从PubMed/MEDLINE和GoogleScholar数据库中广泛收集了讨论KCN先进成像技术和治疗方案的相关出版物.以下索引术语和关键字用于在线搜索:圆锥角膜,圆锥角膜的诊断,圆锥角膜诊断的进展,地形图或层析成像,眼前节光学相干断层扫描,圆锥角膜的治疗,圆锥角膜的治疗进展,胶原蛋白交联,基质内环,角膜移植术,和圆锥角膜的新技术。
■各种筛查方法,如角膜地形图,断层摄影术,眼前节光学相干断层扫描,和评估角膜生物力学已经开发出来,以在早期阶段识别KCN。诊断后,KCN管理侧重于预防疾病进展。角膜胶原交联是一种微创治疗,可以减缓或停止病情的发展。最近的研究还探索了使用硫酸铜滴眼液(IVMED-80)作为非侵入性治疗来预防KCN的进展。目前改善视力的治疗方案包括巩膜晶状体,角膜内环段,角膜同种异体基质内环节段,和深板层角膜移植术。最近,新颖的替代程序,比如孤立的Bowman层移植,作为角膜基质嵌体或高嵌体,表现出令人鼓舞的结果。人工智能已被接受为KCN的诊断和管理提供最佳实践,它的应用科学受到了争议;然而,它可能没有得到充分发展。
■使用当前成像方式的早期检测和筛查方法的进步改善了KCN的诊断。通过精心设计,可以提高当前筛查或诊断测试的准确性以及比较它们的有效性,大规模,前瞻性研究。目前正在研究KCN新兴治疗的安全性和有效性。有一个持续的研究需要跟踪进展和评估临床医生的知识和实践在治疗KCN患者。考虑到当前可用的成像方式和治疗选择,管理方法中的人工智能能力将使患者受益最大。
UNASSIGNED: Keratoconus (KCN) is characterized by gradual thinning and steepening of the cornea, which can lead to significant vision problems owing to high astigmatism, corneal scarring, or even corneal perforation. The detection of KCN in its early stages is crucial for effective treatment. In this review, we describe current advances in the diagnosis and treatment of KCN.
UNASSIGNED: This narrative review focuses on recent advancements in the diagnosis and treatment of KCN, especially evolving approaches and strategies. To ensure the inclusion of the most recent literature, relevant publications discussing advanced imaging techniques and treatment options for KCN were extensively gathered from the PubMed/MEDLINE and Google Scholar databases. The following index terms and keywords were used for the online search: keratoconus, diagnosis of keratoconus, advances in the diagnosis of keratoconus, topography or tomography, anterior segment optical coherence tomography, treatment of keratoconus, advances in the treatment of keratoconus, collagen crosslinking, intrastromal ring, keratoplasty, and new techniques in keratoconus.
UNASSIGNED: Various screening methods such as corneal topography, tomography, anterior segment optical coherence tomography, and assessment of corneal biomechanics have been developed to identify KCN in its early stages. After diagnosis, KCN management focuses on preventing disease progression. Corneal collagen crosslinking is a minimally invasive treatment that can slow or stop the progression of the condition. Recent research has also explored the use of copper sulfate eye drops (IVMED-80) as a noninvasive treatment to prevent the progression of KCN. Current treatment options for visual improvement include scleral lenses, intracorneal ring segments, corneal allogeneic intrastromal ring segments, and deep anterior lamellar keratoplasty. Recently, novel alternative procedures, such as isolated Bowman layer transplantation, either as a corneal stromal inlay or onlay, have demonstrated encouraging outcomes. Artificial intelligence has gained acceptance for providing best practices for the diagnosis and management of KCN, and the science of its application is contentiously debated; however, it may not have been sufficiently developed.
UNASSIGNED: Early detection and advancements in screening methods using current imaging modalities have improved diagnosis of KCN. Improvement in the accuracy of current screening or diagnostic tests and comparison of their validities are achievable by well-designed, large-scale, prospective studies. The safety and effectiveness of emerging treatments for KCN are currently being investigated. There is an ongoing need for studies to track progress and evaluate clinicians\' knowledge and practices in treating patients with KCN. Artificial intelligence capabilities in management approach considering the currently available imaging modalities and treatment options would best benefit the patient.