Prevalence of keratoconus in refractive surgery practice population in North Macedonia

Gilevska, Fanka; Kostovska, Biljana; Osmani, Ilir; Biščević, Alma; Suić, Smiljka Popović; Bohač, Maja; Patel, Sudi

doi:10.1007/s10792-022-02319-0

Cited by 9 publications

(11 citation statements)

References 30 publications

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“…In a meta-analysis study 19 revising clinical data from 29 articles on 7.158.241 participants from 15 countries, eye rubbing, allergy, asthma, eczema, and positive family history of keratoconus have been found as the most important risk factors for this disease; gender did not correlate with keratoconus, as found here and in previous studies. 25,32 On the other hand, male preponderance has been noted in some studies 14,17,29,30 ; it could not be excluded that discrepancies in the results among studies could be due to intergender differences in the incidence of keratoconus in different age groups. In a Chinese report, the prevalence of keratoconus in first-degree relatives was about 9% and the CLEK study found a positive family history of keratoconus in 13% of the patients.…”

Section: Discussionmentioning

confidence: 98%

“…16 Of note, a disease prevalence of 12% has been recently found in a retrospective study reviewing 2812 patients charts in an ophthalmological care institution seeking for refractive surgery in Macedonia. 29 Disease prevalence has been found to be relatively low in northern Europe, including data from Denmark (0.04% -collecting data from 1977 to 2015), 18 Norway (0.19%data from 2010 to 2018) 17 and the Netherlands (0.27%data from 2011 to 2019) 20 , although data source have been obtained from national patient registers, thus largely underestimating the true prevalence in the general population due to missed diagnosis by corneal topography. In Australasia and China, the reported disease prevalence ranged between 0.5% and 1.5%; in particular, it has been found to range between 0.5% and 1.2% in New Zealand and Australia respectively.…”

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

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Estimated prevalence of keratoconus in the largest metropolitan area of Italy

Lombardo,

Alunni Fegatelli,

Serrao

et al. 2024

European Journal of Ophthalmology

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Purpose To estimate the prevalence of keratoconus in a population of subjects undergoing first eye examination in an eye clinic in Italy. Methods A single-center, cross-sectional, study was conducted involving patients who underwent first eye examination at an eye clinic in Rome between September 2021 and June 2022. The prevalence of keratoconus was determined by Placido-disk corneal topography using the maximum keratometry (Kmax) value and the Cone Magnitude and Location Index (CLMI) for keratoconus screening. Subjective analysis was performed by two experienced corneal specialists, who classified the outcome into two groups: normal and keratoconus. Risk factors, including family history of keratoconus, allergy or atopy, thyroid disease, eye rubbing habit and gender were also examined. Results A total of 512 subjects between 7 and 81 years old were evaluated. The inter-observer agreement to classify subjects in normal or keratoconus group was excellent (k = 1.0); the estimated prevalence in the specific population was 2.1%. Presence of positive family history (9% of keratoconus vs 5% normal), concomitant allergy or atopy (27% vs 9%) and eye rubbing habit (18% vs 4%) were associated with a higher risk of disease. Conclusion This study reported a high estimated prevalence of keratoconus in a metropolitan area of Italy, as found in recent studies in the Mediterranean and Middle East countries. Screening for keratoconus is highly recommendable and easily feasible with corneal topography under expert supervision and may be indicated primarily in young population to improve early detection and prompt therapeutic management for halting disease progression.

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Section: Discussionmentioning

confidence: 98%

Section: Discussionmentioning

confidence: 99%

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Estimated prevalence of keratoconus in the largest metropolitan area of Italy

Lombardo,

Alunni Fegatelli,

Serrao

et al. 2024

European Journal of Ophthalmology

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“…The prevalence of KC varies considerably among different populations. One of the lowest incidence rates (0.0068%) has been reported in North Macedonia ( 2 ), and the highest prevalence rate (4.79%) is found among paediatric patients in Saudi Arabia ( 3 ). According to a meta-analysis, the frequency of KC in the general population is estimated to equal 1.3/1000 ( 4 ).…”

Section: Introductionmentioning

confidence: 99%

Identification of the immune-associated characteristics and predictive biomarkers of keratoconus based on single-cell RNA-sequencing and bulk RNA-sequencing

Niu,

Xu,

Zhu

et al. 2023

Front. Immunol.

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BackgroundWhether keratoconus (KC) is an inflammatory disease is currently debated. Hence, we aimed to investigate the immune-related features of KC based on single-cell RNA sequencing (scRNA-seq) and bulk RNA sequencing (bulk RNA-seq) data.MethodsscRNA-seq data were obtained from the Genome Sequence Archive (GSA), bulk RNA-seq data were obtained from the Gene Expression Omnibus (GEO), and immune-associated genes(IAGs) were obtained from the ImmPort database. Cell clusters of KC were annotated, and different cell clusters were then selected. The IAG score of each cell was calculated using the AUCell package. Three bulk RNA-seq datasets were merged and used to identify the differentially expressed genes (DEGs), biological functions, and immune characteristics. Weighted gene coexpression network analysis (WGCNA) was used to select the IAG score-related hub genes. Based on scRNA-seq and bulk RNA-seq analyses, three machine learning algorithms, including random forest (RF), support vector machine (SVM), and least absolute shrinkage and selection operator (LASSO) regression analysis, were used to identify potential prognostic markers for KC. A predictive nomogram was developed based on prognostic markers.ResultsSix cell clusters were identified in KC, and decreased corneal stromal cell-5 (CSC-5) and increased CSC-6 were found in KC. CSC and immune cell clusters had the highest IAG scores. The bulk RNA-seq analysis identified 1362 DEGs (553 upregulated and 809 downregulated) in KC. We found different immune cell populations and differentially expressed cytokines in KC. More than three key IAG score-related modules and 367 genes were identified. By integrating the scRNA-seq and bulk RNA-seq analyses, 250 IAGs were selected and then incorporated into three machine learning models, and 10 IAGs (CEP112, FYN, IFITM1, IGFBP5, LPIN2, MAP1B, RNASE1, RUNX3, SMIM10, and SRGN) were identified as potential prognostic genes that were significantly associated with cytokine and matrix metalloproteinase(MMP)1-14 expression. Finally, a predictive nomogram was constructed and validated.ConclusionTaken together, our results identified CSCs and immune cell clusters that may play a key role during KC progression by regulating immunological features and maintaining cell stability.

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“…Highly progressive cases render it difficult to fit rigid contact lenses, by which time corneal transplantation becomes necessary [ 4 ]. Other than INTACS ® (Toronto, ON, Canada), penetrating keratoplasty is easily one of the most common surgical approaches, even though the latter procedure is fraught with fairly high rates of post-operative complications, including secondary glaucoma, cataracts, and graft rejection [ 4 , 5 , 6 , 7 ]. UV light-mediated corneal collagen crosslinking has been used for the last two decades and is the only treatment that has been shown to be effective in slowing the progression of the disease [ 1 , 8 , 9 , 10 , 11 ].…”

Section: Introductionmentioning

confidence: 99%

The Lifetime Expenditure in People with Keratoconus in Saudi Arabia

Al-Atawi

Ali

Alzahrani

2023

Vision

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Aim: This study measured and evaluated the socioeconomic burden of people living with keratoconus in Saudi Arabia. Methods: This study employed a cross-sectional design, a Keratoconus Economic Burden Questionnaire, and a convenient sample of 89 keratoconus patients (58.4% male) drawn from multiple regions in Saudi Arabia. It was conducted using online surveys, and the data were analyzed using appropriate quantitative techniques. Results: The mean age and annual income of the participants were 33.24 (SD = 6.82) years and USD 9046.52 (SD = 16,866.48), respectively, with only 37% being employed for wages. Up to 94.4% needed glasses or contact lenses at least once a week, and 73.0% received care from optometrists. The condition forced 45.9% of the respondents to change careers or leisure activities, with a further 51.3% having to take time off work. The mean annual out-of-pocket expenses for buying and maintaining glasses or contact lenses, as well as traveling and accommodation for keratoconus-related treatment were USD 2341.76 (SD = 3053.09), with 48.32 incurring upwards of USD 3240 over the period. The treatment costs increased with disease duration, r(89) = 0.216, p < 0.05. Regression results showed that the existence of comorbid eye disease, changing glasses at least once a year, and wearing either glasses or contact lenses at least once a week individually had statistically significant negative effects on the total annual keratoconus treatment costs, while disease duration, utilization of optometrists, and taking time off had a statistically significant increase on the total cost (p < 0.05). Conclusion: With a prevalence rate of 1 in 375, progressive debilitation, and the lifetime nature of the disease, keratoconus is a critical public health concern in Saudi Arabia. The resulting visual impairment and discomfort, as well as both direct and indirect economic burdens, have considerable impacts on the patient’s quality of life.

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Prevalence of keratoconus in refractive surgery practice population in North Macedonia

Cited by 9 publications

References 30 publications

Estimated prevalence of keratoconus in the largest metropolitan area of Italy

Estimated prevalence of keratoconus in the largest metropolitan area of Italy

Identification of the immune-associated characteristics and predictive biomarkers of keratoconus based on single-cell RNA-sequencing and bulk RNA-sequencing

The Lifetime Expenditure in People with Keratoconus in Saudi Arabia

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