Causes Of Tomographic Pseudoectasia – Pearls To Prevent Misdiagnosis

Published 2022 - 40th Congress of the ESCRS

Reference: FPS03.04 | Type: Free paper | DOI: 10.82333/sr49-v250

Authors: Eitan Livny* ¹ , Alexander Chorny ² , Yoav Nahum ³ , Ruti Sela ³ , Ori Mahler ⁴ , Asaf Gershoni ³ , Irit Bahar ³

¹Ophthalmology,Rabin Medical Center,Petach Tikva,Israel;Sackler Faculty of Medicine,Tel Aviv University,Tel Aviv,Israel, ²Ophthalmology,Faculty of Health Sciences,Be'er Sheva,Israel, ³Ophthalmology,Rabin Medical Center,Petach Tikva,Israel, ⁴Ophthalmology,Shamir Medical Center,Be'er Yaakov,Israel

Purpose

To describe a series of patients that were previously diagnosed with corneal ectasia based on their tomography and topography data. Upon further examinations and Anamnesis review, the diagnosis was changed and corneal ectasia was ruled out.

Setting

Two tertiary hospital Ophthalmology departments in Israel

Methods

Descriptive case series

Results

Eight patients were identified with tomographic pseudoectasia. The underlying etiologies were: diffuse Salzmann nodule producing ectasia-like anterior corneal elevation on tomography, Erroneous Pentacam settings (best-fit-sphere inacurracy), strabismus with inability to align the deviating eye with the target point, a case of anisometropic Lasik surgery - Hyperopic Tx in the right eye and Myopic in left eye (giving false impression of right eye post-Lasik ectasia), Late stromal haze after PRK treatment, Posterior Polymorphous dystrophy leading to an ectasia-like posterior elevation map, and higher-than-normal tear meniscus that led to false impression of ectasia in the sagittal map.

Conclusions

Ectasia-mimicking topographies/tomographies are rare. This case series describes causes for pseudoectasia that were not previously reported. The comprehensive ophthalmologist should be aware of such cases, which may substantially alter the treatment and prognosis of these patients