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Predictive accuracy of the ABCD progression display among patients with keratoconus: A historic cohort analysis

Eye volume 37, pages 1834–1839 (2023)Cite this article

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A Correction to this article was published on 03 February 2023

This article has been updated

Abstract

Objective

To evaluate the accuracy of the ABCD Progression Display and the ABCD grading system in a population of adult patients with keratoconus.

Methods

A retrospective cohort analysis of all adult patients with keratoconus followed at the Shamir Medical Center between 2012 and 2017. A recommendation by the cornea specialist to undergo corneal crosslinking (CXL) was used as a surrogate of ectasia progression. The ABCD grading was not available to the treating physician and was computed post-hoc. Sensitivity and specificity of the ABCD Progression Display was calculated, and multivariate regression was used to estimate the risk to undergo CXL when the ABCD Progression Display indicated progression. The ABCD grading was compared between patients who required CXL to those who did not. A single eye of each patient was included. Sensitivity and specificity of the ABCD Progression Display were 82% and 73%, respectively. A multivariable model adjusted for possible confounders, found that ABCD Progression was associated with a 7-fold risk of undergoing CXL compared to a patient in whom progression was not recorded in the ABCD Progression Display (OR = 7.55; 95% CI = 3.82–14.93, p < 0.001).

Results

293 eyes of 293 patients were analysed. Mean age at presentation was 26.92 ± 6.12 years. In 68 eyes, progression of keratoconus was recorded and CXL was performed (CXL-group).

Conclusion

The ABCD Progression Display demonstrated adequate sensitivity and specificity and high predictive capabilities of keratoconus progression. It can be effectively utilized as an initial screening test in adults with keratoconus.

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Fig. 1: Change in ABC parameters from baseline visit.

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Data availability

The datasets generated and/or analyzed during the current study are available from the corresponding author on reasonable request.

Change history

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Acknowledgements

This research received no specific grant from any funding agency in the public, commercial, or not-for-profit sectors.

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Authors and Affiliations

  1. Department of Ophthalmology, Shamir Medical Center (formerly Assaf-Harofeh), Tzrifin, Israel

    Biana Dubinsky-Pertzov, Idan Hecht, Inbal Gazit, Lior Or, Asaf Shemer, Eran Pras & Adi Einan-Lifshitz

  2. Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel

    Biana Dubinsky-Pertzov, Omri Segal, Idan Hecht, Inbal Gazit, Lior Or, Asaf Shemer, Eran Pras & Adi Einan-Lifshitz

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  1. Biana Dubinsky-Pertzov
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Contributions

BDP was responsible for designing the protocol, interpreting results and led the writing of the manuscript. OS were responsible for extracting the data and contributed to the writing of the final manuscript. IG was responsible for extracting the data. LO and AS were responsible for analysing data and interpreting results. IH contributed to result interpretation and the writing of the final manuscript. EP contributed to the protocol design, interpretation of results and writing the final manuscript. AEL devised and supervised the project and the main conceptual ideas, contributed to the final manuscript. All authors discussed the results and contributed to the final manuscript.

Corresponding author

Correspondence to Biana Dubinsky-Pertzov.

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Competing interests

The authors declare no competing interests.

Ethical approval

The study was conducted in accordance with the tenets of the Declaration of Helsinki, and approval was obtained from the institutional review board.

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The original online version of this article was revised: The Abstract was given incomplete: The last sentences under Methods was missing. The missing sentence is: Sensitivity and specificity of the ABCD Progression Display were 82% and 73%, respectively. A multivariable model adjusted for possible confounders, found that ABCD Progression was associated with a 7-fold risk of undergoing CXL compared to a patient in whom progression was not recorded in the ABCD Progression Display (OR = 7.55; 95% CI = 3.82–14.93, p < 0.001).

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Dubinsky-Pertzov, B., Segal, O., Hecht, I. et al. Predictive accuracy of the ABCD progression display among patients with keratoconus: A historic cohort analysis. Eye 37, 1834–1839 (2023). https://doi.org/10.1038/s41433-022-02242-9

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