Keratoconus has been classically defined as a progressive, non-inflammatory condition, which produces a thinning and steepening of the cornea. Its pathophysiological mechanisms have been investigated for a long time. Both genetic and environmental factors have been associated with the disease. Recent studies have shown a significant role of proteolytic enzymes, cytokines, and free radicals; therefore, although keratoconus does not meet all the classic criteria for an inflammatory disease, the lack of inflammation has been questioned. The majority of studies in the tears of patients with keratoconus have found increased levels of interleukin-6 (IL-6), tumor necrosis factor-α (TNF-α), and matrix metalloproteinase (MMP)-9. Eye rubbing, a proven risk factor for keratoconus, has been also shown recently to increase the tear levels of MMP-13, IL-6, and TNF-α. In the tear fluid of patients with ocular rosacea, IL-1α and MMP-9 have been reported to be significantly elevated, and cases of inferior corneal thinning, resembling keratoconus, have been reported. We performed a literature review of published biochemical changes in keratoconus that would support that this could be, at least in part, an inflammatory condition.

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None of the authors has a financial or proprietary interest in any material or method mentioned.

a b s t r a c tAmong the classical minor structural associations on the termination of transcurrent faults are horsetail splays formed by reverse, normal or strike-slip faults developing duplexes. However, temporal and spatial coexistence of contractional and extensional structures is very rarely documented. We discuss the relationships of contractional and extensional structures and associated sedimentary depocenters at the termination of a major strike-slip fault in the Eastern Betic Cordillera. Field mapping, kinematic fault analysis, paleostress determination and gravity prospecting in the Huércal-Overa Basin, at the southern termination of the NE-SW Alhama de Murcia transcurrent fault (AMF), are used to establish the relationships of tectonic structures and associated sedimentary depocenters. Here, ENE-WSW and WNW-ESE folds interact with two sets of normal faults having the same orientation as well as ENE-WSW reverse faults. Progressive unconformities associated with folds reveal that the beginning of the AMF activity occurred in the Tortonian. The folds progressively grew and rotated from ENE-WSW up to WNW-ESE close to the transcurrent fault. We propose that the development of the normal faults developed during short-term episodes characterized by vertical major stress axis and are, in turn, related to gravitational instability linked to the thickening of a crust relatively hot at depth. This setting may have become predominant in between the main activity, compressive pulses along transcurrent faults.