Effect of Allergic Diseases on Keratoconus Severity

Naderan, Mohammad; Rajabi, Mohammad Taher; Zarrinbakhsh, Parviz; Bakhshi, Anahita

doi:10.3109/09273948.2016.1145697

Cited by 52 publications

(40 citation statements)

References 32 publications

(66 reference statements)

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“…[ 1 8 9 ] Patients with VKC and family history of AED are at increased risk of KC incidence, severity, and progression. [ 10 11 ] VKC is a chronic allergic disease affecting tarsal conjunctiva and limbus. [ 12 13 ] It is an IgE-mediated hypersensitivity reaction where binding of allergen-specific IgE to high-affinity IgE receptors on mast cells releases histamines and other cytokines causing inflammation.…”

Section: Discussionmentioning

confidence: 99%

Allergen-specific exposure associated with high immunoglobulin E and eye rubbing predisposes to progression of keratoconus

Shetty

Sureka

Kusumgar

et al. 2017

Indian J Ophthalmol

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We report two male children with persistent allergic eye disease (AED) and keratoconus (KC). Both presented with symptoms of vernal keratoconjunctivitis and decreased vision. In view of unrelenting AED, serum immunoglobulin E (IgE) quantification and identification of specific allergens were advised. Increased serum IgE levels were observed in both cases. Sunflower and sheep wool were identified as specific allergens for the first and second patient respectively by skin patch test. There was complete resolution of symptoms of AED in both patients following avoidance of causative allergens. However, the progression of KC in both eyes of the first patient and one eye of the second patient was observed. They were advised collagen cross-linking. Elevated serum IgE indicates the presence of systemic allergy. Avoiding implicated allergens help alleviate ocular symptoms. Using serum IgE and identifying specific allergen can guide in the treatment of AED and thus prevent progressive KC due to eye rubbing and resulting inflammation.

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Section: Discussionmentioning

confidence: 99%

Allergen-specific exposure associated with high immunoglobulin E and eye rubbing predisposes to progression of keratoconus

Shetty

Sureka

Kusumgar

et al. 2017

Indian J Ophthalmol

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“…e conclusions reached in our study showed a significant association between allergic diseases including allergic rhinitis, asthma, atopic dermatitis, and the presence of keratoconus. An earlier study also reported that atopic diseases including asthma, vernal keratoconjunctivitis, atopic keratoconjunctivitis, and seasonal or perennial allergic keratoconjunctivitis were associated with keratoconus, and their prevalence in keratoconus patients had a higher incidence than the control group [18]. e most common cause of keratoconus is thought to be frequent eye rubbing, and pruritis associated with atopy and other allergic conditions leads to eye rubbing [19][20][21][22][23][24].…”

Section: Discussionmentioning

confidence: 92%

Incidence of Keratoconus and Its Association with Systemic Comorbid Conditions: A Nationwide Cohort Study from South Korea

Moon

Lee

Park

et al. 2020

Journal of Ophthalmology

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Purpose. To determine the incidence of keratoconus and to determine its possible association with common systemic diseases using a nationwide cohort. Methods. This retrospective nationwide cohort study included 1,025,340 subjects from the Korean National Health Insurance Service-National Sample Cohort database from 2004 to 2013. Estimates for incidence rates of keratoconus were identified. After 1 : 5 matching using propensity scores, associations between keratoconus and certain systemic comorbidities were determined using multivariate logistic regression analysis. Results. The incidence during the same period was 15.1 cases per 100,000 person-years. Adjusted logistic regression analysis after propensity score matching revealed significant associations between keratoconus and allergic rhinitis (odds ratio (OR): 1.86; 95% confidence interval (CI): 1.63–2.13; p<0.001), asthma (OR: 1.20; 95% CI: 1.06–1.36; p<0.001), atopic dermatitis (OR: 1.33; 95% CI: 1.13–1.56; p<0.001), and diabetes mellitus (DM) (OR: 1.35; 95% CI: 1.15–1.58; p<0.001). Conclusion. Estimates of the incidence of keratoconus may help in the planning of eye-care policies, and the results of this study determined the associations between allergic diseases and keratoconus. Conflicting results regarding the association between keratoconus and DM should be further evaluated.

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“…Patients with a history of ocular trauma or surgery, cross‐linking, or concurrent ophthalmic disorders such as glaucoma, severe dry eye, corneal infections, axial myopia, autoimmune or connective tissue disorders, chronic disorders that may affect the eye, atopy and allergic diseases, thyroid diseases, pregnant or nursing women, and those with severe eye‐rubbing habits, were excluded from the study due to the probable influence of these conditions on disease severity in patients with KC …”

Section: Methodsmentioning

confidence: 99%

Clinical biomicroscopy and retinoscopy findings of keratoconus in a Middle Eastern population

Naderan

Jahanrad

Farjadnia

2018

Clinical and Experimental Optometry

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Background: The present work was conducted to investigate the prevalence of clinical biomicroscopy and retinoscopy findings of corneas with keratoconus (KC) at first presentation and their relationship with disease severity. Method: In a prospective cross-sectional study, 371 consecutive KC patients were examined by slitlamp biomicroscopy and retinoscopy at the time of diagnosis. This research evaluates the prevalence of clinical findings such as a corneal protrusion, Vogt's striae, Fleischer's ring, Munson's sign, Rizzuti's sign, corneal scars, as well as any additional KC signs such as prominent nerve fibres, scissoring reflex and Charleaux 'oil droplet' sign on retinoscopy. Keratometry (mean K), central and thinnest corneal thickness (CCT and TCT), anterior and posterior elevation (AE and PE), and astigmatism by means of Pentacam, and visual acuity (VA) were recorded for each patient. The severity of KC was graded on the basis of the Keratoconus Severity Score. Results: Corneal protrusion, scissoring reflex, corneal thinning, Fleischer's ring, and prominent nerve fibres were the most prevalent findings in the keratoconic corneas (71.7 per cent, 64.2 per cent, 56.6 per cent, 55.5 per cent and 54.7 per cent, respectively). Those KC patients with these clinical findings had significantly higher mean K, AE and PE, while having significantly lower CCT, TCT and VA compared to those who did not present these signs (p < 0.05). The presence of clinical findings was associated with more severe disease (p < 0.001, all comparisons). Wearing contact lenses was associated with the increase in the risk of corneal scarring (p = 0.009, odds ratio = 1.761, 95 per cent confidence interval = 1.126 to 2.755). Conclusion: This study provided information regarding the presence of the clinical slitlamp biomicroscopic and retinoscopic findings with severity of KC. A positive association was found between the presence of clinical signs and topographic parameters. In addition, wearing contact lenses was associated with the increase in the risk of corneal scarring.

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Effect of Allergic Diseases on Keratoconus Severity

Abstract: Patients with VKC or AC were at increased risk of KC. They had more severe KC and should be closely followed up and intensively treated.

Cited by 52 publications

References 32 publications

Allergen-specific exposure associated with high immunoglobulin E and eye rubbing predisposes to progression of keratoconus

Allergen-specific exposure associated with high immunoglobulin E and eye rubbing predisposes to progression of keratoconus

Incidence of Keratoconus and Its Association with Systemic Comorbid Conditions: A Nationwide Cohort Study from South Korea

Clinical biomicroscopy and retinoscopy findings of keratoconus in a Middle Eastern population

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