Résumé
There are many clinical and topographic classifications of keratoconus but only one, proposed by Sandali et al., used optical coherence tomography (OCT) to evaluate the corneal structure. The purpose of this study was to evaluate the classification in clinical practice.Methode: we performed a retrospective analysis of all patients with keratoconus who consulted at Montpellier University Hospital between July 2018 and July 2020. The diagnosis of keratoconus was based on a range of clinical and topographic features. Exclusion criteria were a history of ocular surgery. Patients with keratoconus were classified according to 5 stages of increasing severity based on the appearance of corneal OCT. We analyzed the functional, clinical and topographic characteristics according to the stages. We also analyzed the error of corneal thickness measurement by topography and described the proposed treatments by stage.Results: we included 143 eyes in 143 patients with keratoconus and 35 eyes in 35 healthy patients. Of the keratoconus patients, 116, 8, 9, 6, and 4 were at stage 1, 2, 3, 4, and 5 of the classification, respectively. The severity of structural damage on OCT was associated with greater severity of functional, anatomic and topographic damage. The difference in corneal thickness measurement between OCT and topography was higher with more severe stage. The proposed treatments for the more severe stages were more invasive.Conclusion: the structural classification examined seems able to classify keratoconus severity. We found similar results to the study of Sandali et al. The classification is not well known by practitioners but could find increasing interest for keratoconus with improvement and wider use of anterior segment OCT.