Impaired Corneal Biomechanical Properties and the Prevalence of Keratoconus in Mitral Valve Prolapse

Abstract

Objective. To investigate the biomechanical characteristics of the cornea in patients with mitral valve prolapse (MVP) and the prevalence of keratoconus (KC) in MVP. Materials and Methods. Fifty-two patients with MVP, 39 patients with KC, and 45 control individuals were recruited in this study. All the participants underwent ophthalmologic examination, corneal analysis with the Sirius system (CSO), and the corneal biomechanical evaluation with Reichert ocular response analyzer (ORA). Results. KC was found in six eyes of four patients (5.7%) and suspect KC in eight eyes of five patients (7.7%) in the MVP group. KC was found in one eye of one patient (1.1%) in the control group (P = 0.035). A significant difference occurred in the mean CH and CRF between the MVP and control groups (P = 0.006 and P = 0.009, resp.). All corneal biomechanical and topographical parameters except IOPcc were significantly different between the KC-MVP groups (P < 0.05). Conclusions. KC prevalence is higher than control individuals in MVP patients and the biomechanical properties of the cornea are altered in patients with MVP. These findings should be considered when the MVP patients are evaluated before refractive surgery.

The Association Between Sociodemographic Factors, Common Systemic Diseases, and Keratoconus

“…31 Akcay and colleagues implicated abnormal or weak collagen structure in both mitral valve prolapse and collagen vascular disease. 32 Similarly, a single-center survey of patients with KCN by Gupta and coworkers found that sleep apnea was more prevalent in patients with KCN than in the general population. 33 These prior studies all had relatively small sample sizes ranging from 25 to 1,529 patients, so for many of these conditions, the researchers were limited in their ability to perform rigorous statistical analyses and adjust for potential confounding factors.…”

Risk of Mitral Valve Prolapse in Patients with Keratoconus in Taiwan: A Population-Based Cohort Study

“…Finally, several studies have shown that the biomechanical characteristics of keratoconic corneas, including corneal hysteresis and corneal resistance factor, were less than those in normal corneas [ 13 , 25 , 26 , 27 ]. Kalkan Akcay et al reported that corneal hysteresis and corneal resistance factor values in patients with MVP were significantly less than those in the control group [ 13 ]. Similar changes in the biomechanical characteristics of the cornea may reflect an association between KCN and MVP.…”

“…The dysregulation of the collagen components plays a key role in the development of these diseases [ 8 , 9 , 11 , 12 ]. Apart from their common pathogenic mechanisms, KCN and MVP are linked to several systemic collagen diseases, including Marfan syndrome, Ehlers–Danlos syndrome, pseudoxanthoma elasticum, and osteogenesis imperfecta [ 3 , 13 , 14 ]. Hence, it is clinically related to explore whether KCN is a risk in the development of MVP.…”

Evaluating corneal changes in patients with Aort aneurysm

“…During embryogenesis, both the corneal stroma and collagen forming the mitral valves occur at the sixth and seventh weeks of fetal life. Therefore, any disorder affecting the fetus in these weeks may affect both structures [11,15] . In 2012 and 2013, Dudokova et al found a decrease in lysyl oxidase (LOX) enzyme in keratoconus patients [8,13] .…”

“…It is essentially a collagen tissue disorder, and various protease inhibitors and proinflammatory cytokines are thought to be involved in its pathogenesis [2,[4][5][6][7][8] . The relation between keratoconus and systemic collagen diseases has been frequently discussed [9][10][11] . The levels of proinflammatory cytokines and proteinases get increased in this disease and subsequently affect all the body organs including the cardiovascular system [12,13] .…”