Clinical characteristics of keratoconus patients at the University of KwaZulu-Natal eye clinic

Rupnarain, Shishka; Madlala, Nomvelo; Memela, Ntokozo; Ngcobo, Simpiwe; Shabalala, Nonkazimulo; Simjee, Naseera; Gcabashe, Nonkululeko; Rampersad, Nishanee

doi:10.4102/aveh.v79i1.528

Cited by 6 publications

(23 citation statements)

References 18 publications

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“…All articles were published between 2007 and 2020, with the majority (11) published within the last 5 years, i.e., 2016-2020. Five of the studies were conducted in Egypt, [32][33][34][35][36] two in South Africa, 37,38 two in Kenya, 39,40 one in Sudan, 41 one in Ghana 42 and one in Nigeria. 43 Two studies were conducted in allergic conjunctivitis patients, 33,39 four on exclusively keratoconus patients, 37,[40][41][42] one in patients seeking contact services, 38 one in pre-LASIK patients, 36 one in refractive patients 32 and one in a student population.…”

Section: Resultsmentioning

confidence: 99%

“…Five of the studies were conducted in Egypt, [32][33][34][35][36] two in South Africa, 37,38 two in Kenya, 39,40 one in Sudan, 41 one in Ghana 42 and one in Nigeria. 43 Two studies were conducted in allergic conjunctivitis patients, 33,39 four on exclusively keratoconus patients, 37,[40][41][42] one in patients seeking contact services, 38 one in pre-LASIK patients, 36 one in refractive patients 32 and one in a student population. 43 Eleven (91.7%) were hospital-based studies 32,33,[36][37][38][39][40][41][42] and one was a school-based study.…”

Section: Resultsmentioning

confidence: 99%

“…43 Two studies were conducted in allergic conjunctivitis patients, 33,39 four on exclusively keratoconus patients, 37,[40][41][42] one in patients seeking contact services, 38 one in pre-LASIK patients, 36 one in refractive patients 32 and one in a student population. 43 Eleven (91.7%) were hospital-based studies 32,33,[36][37][38][39][40][41][42] and one was a school-based study. 43 The lowest sample size was 78 42 and the highest was 8,124 32 ; the total sample size was 15,312.…”

Section: Resultsmentioning

confidence: 99%

“…The overall prevalence of keratoconus in Africa was pooled from eight studies [32][33][34][35][36]38,39,43 as these were the only investigations to report the prevalence of keratoconus. The range of prevalences was 0.4%-30.9%.…”

Section: Resultsmentioning

confidence: 99%

“…46 The high keratoconus prevalence noted here might be because almost all of the included studies were conducted in cohorts at high risk of keratoconus or in a population with high possibility of finding keratoconus patients. Seven out of the eight studies included in the metaanalysis were conducted on patients having allergic conjunctivitis, 33,39 refractive care, 32,35 seeking contact lenses 38 or refractive surgery. 34,36 We also observed that the majority (7) of studies conducted in Africa adopted a hospital-based design whereas most from Western and Asian countries employed population-based designs.…”

Section: Discussionmentioning

confidence: 99%

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Keratoconus in Africa: A systematic review and meta‐analysis

Akowuah

Kobia‐Acquah

Donkor

et al. 2021

Ophthalmic Physiologic Optic

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The aim of this review is to evaluate the prevalence of and factors associated with keratoconus in Africa. Method: A systematic online literature search was conducted for articles on keratoconus in Africa. Meta-analysis was performed to estimate the prevalence of keratoconus in Africa. The Freeman-Tukey double arcsine transformation was used to minimize the effects of studies with extremely high or low prevalence estimates on the overall pooled estimates. Leave-one-out sensitivity analysis was used to assess the robustness of the pooled effects and potential outliers. Meta-regression was performed to explore associations between keratoconus, gender and age. Results: Twelve studies were included in the review; 5 from Egypt, 2 from South Africa, 2 from Kenya, 1 from Sudan, 1 from Ghana and 1 from Nigeria. Two studies were conducted in allergic conjunctivitis patients, 4 in keratoconus patients, 1 in contact lens service seekers, 1 in pre-LASIK patients, 1 in refractive patients and 1 in a student population. Eight studies were included in the meta-analysis. The overall prevalence estimate of keratoconus in Africa was 7.9% (95% CI: 2.5%-16.0%). The prevalence of keratoconus among males and females in Africa was estimated to be 9.3% (95% CI: 2.5%-19.5%) and 5.8% (95% CI: 1.5%-12.7%) respectively. The estimated prevalence of unilateral and bilateral keratoconus was 2.6% (95% CI: 0.4%-6.5%) and 5.8% (95% CI: 1.6%-12.3%), respectively. The estimated prevalence of mild keratoconus was 2.2% (95% CI: 0.7%-4.7%), moderate keratoconus was 3.5% (95% CI: 0.0%-11.8%) and severe keratoconus was 4.0% (95% CI: 0.0%-19.6%). There was no significant association between gender and the prevalence of keratoconus in Africa (p = 0.63), and age and the prevalence of keratoconus in Africa (p = 0.78). Conclusion:The estimated prevalence of keratoconus reported here is higher than prevalence values reported in other meta-analyses or different geographical locations. This is mainly because studies included in this meta-analysis were either conducted on a cohort at high risk of keratoconus or a population with high possibility of finding keratoconus patients. There is a dearth of well-designed population-based studies on keratoconus in Africa, resulting in a lack of epidemiological information. This highlights the urgent need for research on keratoconus in Africa.

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Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

See 3 more Smart Citations

Keratoconus in Africa: A systematic review and meta‐analysis

Akowuah

Kobia‐Acquah

Donkor

et al. 2021

Ophthalmic Physiologic Optic

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Prevalence of keratoconus in Ghana: A hospital-based study of tertiary eye care facilities

Kobia‐Acquah

Senanu

Antwi-Adjei

et al. 2022

European Journal of Ophthalmology

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Purpose To estimate the prevalence of keratoconus in tertiary eye care facilities in Ghana. Methods and Analysis In this hospital-based retrospective cohort study, medical records of patients from tertiary/referral eye care facilities in Ghana were reviewed. Included in the study were records of individuals who visited the eye care facilities and were diagnosed of keratoconus within the period of January 2016 to December 2019 inclusive. Data on patients’ demographics, severity of keratoconus, mode of diagnosis, treatment, and visual acuity outcomes were analysed. Results Out of the total of 142,209 records reviewed, 75 patients were diagnosed of keratoconus in at least one eye (127 eyes; 86.8% bilateral cases), representing a prevalence estimate of 53 per 100000 (95% confidence interval (CI): 41 to 65 per 100000). The mean ± SD age of patients at the time of diagnosis was 21.1 ± 9.5 years (66.2% males). The mean ± SD keratometry in keratoconus patients was 52.1 ± 7.0: majority (76.5%) of the cases were moderate to severe keratoconus. The main primary treatment regimen was corneal transplant (58.8%) followed by spectacles (25.0%), crosslinking (8.8%) and rigid contact lens (7.3%). There was a significant association between post-treatment visual acuity outcomes and treatment type (p < 0.001). Conclusion Our study represents the first prevalence estimate of keratoconus in Ghana. The prevalence of keratoconus estimated in our study is lower than that reported in countries with tropical climates. This could be due to lower uptake of referrals, underdiagnosis and/or misdiagnosis of the condition in lower-level health facilities.

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Prevalence and demographic profile of keratoconus among high school students in Kenya

Rashid,

Moodley,

Mashige

2023

Preprint

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Background To determine the prevalence and demographic profile of keratoconus (KC) among high school students in Nairobi County, Kenya. Methods In this population-based, prospective, cross-sectional study, multistage cluster sampling was used to select the participants. All students underwent visual acuity measurement, auto-refraction, retinoscopy and corneal topography. Students with corneal topography patterns suspicious of KC were referred for corneal tomography. Results A total of 3 051 students from 29 schools, with a mean age of 17.4 ± 1.6 years (range: 13–25 years) were screened. The prevalence of KC was 1.7% (n = 51) (95% CI, 1.2–2.2) and of KC suspects was 3.8% (n = 117) (95% CI, 3.2–4.6). There were no significant associations between the prevalence of KC and gender, age or ethnicity (all p > 0.05). In the KC group, 88.2% (n = 45) were unaware of their condition, 52.9% (n = 27) were treated for allergic conjunctivitis, 45.1% (n = 23) required spectacles, 11.8% (n = 6) were recommended contact lenses in at least one eye and 49.0% (n = 25) were recommended corneal cross-linking. Conclusions

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Clinical characteristics of keratoconus patients at the University of KwaZulu-Natal eye clinic

Cited by 6 publications

References 18 publications

Keratoconus in Africa: A systematic review and meta‐analysis

Keratoconus in Africa: A systematic review and meta‐analysis

Prevalence of keratoconus in Ghana: A hospital-based study of tertiary eye care facilities

Prevalence and demographic profile of keratoconus among high school students in Kenya

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