Keratoconus Progression Induced by In Vitro Fertilization Treatment

Abstract

Drugs used in IVF treatment increase estrogen levels, which may affect corneal biomechanics and induce progression of keratoconus. Corneal cross-linking treatment could be offered to minimize the risk of keratoconus progression before IVF treatment.

A Review of Structural and Biomechanical Changes in the Cornea in Aging, Disease, and Photochemical Crosslinking

“…Tabibian et al (2017) showed that pregnancy-related changes in thyroid hormones are associated with changes in corneal hysteresis and corneal resistance. Several studies have highlighted patients, some of whom previouslyH received CXL treatment for keratoconus, having rapid progression of keratoconus after significant hormone changes (Yuksel et al, 2016; Lee et al, 2018; Torres-Netto et al, 2019). Further, cornea biomechanics are shown to change with the menstrual cycle (Goldich et al, 2011).…”

Prolactin-Induced Protein is a novel biomarker for Keratoconus

“…It has been shown that corneal thickness changes occur during the menstrual cycle and that pregnancy may be a risk factor for KC progression (Ghahfarokhi et al, 2015;Naderan and Jahanrad, 2017), both of which highlight the role of sex hormones in KC. Yuksel et al also observed hormonally driven acceleration of corneal thinning in three KC patients undergoing estrogen treatment for in vitro fertilization (Yuksel et al, 2016). Despite these connections, hormone receptors and their role within the cornea remain understudied (Gupta et al, 2005).…”

Tear Mediators NGF along with IL-13 Predict Keratoconus Progression

“…3 The etiology of this visually debilitating disease is not yet known in detail, but recent studies suggest that the pathogenesis is related to a combination of genetic, biomechanical, biochemical and environmental risk factors including inflammation, oxidative stress, and allergy. [4][5][6][7][8][9][10][11][12][13][14][15][16] Altered levels of various cytokines, enzymes, regulatory and growth factors, and diagnostic markers of inflammation and tissue injury have been found in the tears or in the cornea of patients with keratoconus, pointing to the crucial role of the immune system in the pathogenesis of keratoconus. 6,[11][12][13][14] These include proinflammatory cytokines (tumor necrosis factor (TNF), interleukin (IL)-1β, IL-6), inflammatory chemokines (CXCL8, CCL5), inflammatory mediators (IL-12, interferon (IFN)-γ, IL-17), the anti-inflammatory cytokine IL-10, cytokines associated with allergy development (IL-4, IL-13), enzymes and their co-factors associated with tissue remodeling (matrix metalloproteinases (MMPs), tissue inhibitor of metalloproteinase-1 (TIMP-1), cathepsin B).…”