Identification and Validation of Functional Biomarkers for Keratoconus
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ClinicalTrials.gov Identifier: NCT01746823 |
Recruitment Status
: Unknown
Verified December 2012 by Dr Rohit Shetty, Narayana Nethralaya.
Recruitment status was: Recruiting
First Posted
: December 11, 2012
Last Update Posted
: March 6, 2014
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Condition or disease | Intervention/treatment |
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Keratoconus | Drug: Cyclosporins |
The screening of keratoconus involves keratoconus related clinical signs like retinoscopy scissors reflex, Munson sign, stromal thinning, Vogt's striae, and Fleischer's ring, but corneal topography is the most useful method in the diagnosis of keratoconus, especially in the absence of clinical signs.
Several devices are currently available for detecting early keratoconus by measuring anterior and posterior corneal topography and elevation(Mihaltz et al. 2009; Ishii et al. 2012). Corneal topographic and tomographic techniques which generate color-coded maps and topographic indices, are the most sensitive devices for confirming the diagnosis of keratoconus(Rabinowitz 1998; Rao et al. 2002) were used for diagnosis in this study. In addition, videokeratography has been shown to identify Forme fruste keratoconus (FFKC) in the absence of clinical signs of keratoconus. Videokeratographic indices such as the Klyce/Maeda criteria, the Rabinowitz criteria, and others have been developed to quantitatively analyze videokeratography and screen for keratoconus(Rao et al. 2002). These indices have been shown to identify keratoconus with a high degree of sensitivity and specificity. The Orbscan II is a three-dimensional slit-scan topography system for analysis of the corneal surfaces and anterior chamber and has been used on all patients in the study. It uses calibrated video and a scanning slit beam to measure x, y, and z locations of several thousand points. These points are used to construct topographic maps(Rao et al. 2002). The Pentacam (Oculus Inc) is a corneal tomographer technology which generates data on topograophy and elevation of anterior and posterior using a rotating Scheimpflug camera which has also been used on all subjects enrolled in this study. Various diagnostic parameters are available for keratoconus diagnosis depending on what mode of topography is being used. Maeda and Klyce designed a system to detect keratoconus. The system, which is based on linear discriminant analysis and a binary decision tree, identifies the map as representing keratoconus or nonkeratoconus and, based on a value from the discriminant analysis (the KPI), assigns the map an index expressed as a percentage that suggests the severity of keratoconus. At this time, however, Keratoconus Severity Index (KSI) and the Amsler-Krumeich classification are the most popular methods for grading keratoconus severity(Mihaltz et al. 2009; Ishii et al. 2012). KSI is based on indices estimated by a curvature map using Placido disk-based corneal topography, and Amsler-Krumeich classification defines the stage of keratoconus using biomicroscopy, mean central keratometry reading, spherical and cylindrical refraction change, and corneal thickness(Mihaltz et al. 2009; Ishii et al. 2012). This is the index that has been used for the final gradation of keratoconus stages of all subjects in this study.
Study Type : | Observational [Patient Registry] |
Estimated Enrollment : | 200 participants |
Observational Model: | Case Control |
Time Perspective: | Prospective |
Target Follow-Up Duration: | 6 Months |
Official Title: | Identification of Disease Progression Specific Biomarkers and Their Pharmacologic Modulation for Keratoconus. |
Study Start Date : | April 2013 |
Estimated Primary Completion Date : | December 2015 |
Estimated Study Completion Date : | December 2015 |

Group/Cohort | Intervention/treatment |
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Controls, Keratoconus
Sub group of Keratoconus to be treated with anti-inflammatory agents ie Cyclosporine-A
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Drug: Cyclosporins
Other Name: Restasis
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- Keratoconus grade specific biomarker identification [ Time Frame: 1 year ]
- Onlabel use of anti-allergic topical treatment for inhibition of specific biomarkers to modify keratoconus disease progression [ Time Frame: 2 years ]
Biospecimen Retention: Samples Without DNA

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Ages Eligible for Study: | 10 Years to 80 Years (Child, Adult, Senior) |
Sexes Eligible for Study: | All |
Accepts Healthy Volunteers: | No |
Sampling Method: | Non-Probability Sample |
Inclusion Criteria:
- Evidence of corneal thinning by any type of keratometry
Exclusion Criteria:
- Corneal inflammation without evidence of ectasia
- Retinal disorder subjects excluded

To learn more about this study, you or your doctor may contact the study research staff using the contact information provided by the sponsor.
Please refer to this study by its ClinicalTrials.gov identifier (NCT number): NCT01746823
India | |
Narayana Nethralaya | Recruiting |
Bangalore, Karnataka, India, 560010 | |
Contact: Rohit Shetty, DNB, FRCS 91-9611102568 drrohitshetty@yahoo.com | |
Principal Investigator: Rohit Shetty, MBBS, DNB, FRCS |
Principal Investigator: | Rohit Shetty, MBBS,DNB, FRCS | Narayana Nethralaya |
Publications:
Publications automatically indexed to this study by ClinicalTrials.gov Identifier (NCT Number):
Responsible Party: | Dr Rohit Shetty, Consultant, Cornea and Refractive Services, Narayana Nethralaya |
ClinicalTrials.gov Identifier: | NCT01746823 History of Changes |
Other Study ID Numbers: |
NNKC-2011 |
First Posted: | December 11, 2012 Key Record Dates |
Last Update Posted: | March 6, 2014 |
Last Verified: | December 2012 |
Keywords provided by Dr Rohit Shetty, Narayana Nethralaya:
Keratoconus Proteomics |
Additional relevant MeSH terms:
Keratoconus Corneal Diseases Eye Diseases Cyclosporins Cyclosporine Enzyme Inhibitors Molecular Mechanisms of Pharmacological Action Immunosuppressive Agents |
Immunologic Factors Physiological Effects of Drugs Antifungal Agents Anti-Infective Agents Dermatologic Agents Antirheumatic Agents Calcineurin Inhibitors |