Progressive corneal ectatic disease in pregnancy

Abstract

Age at pregnancy (years): 33Signs: 19 weeks gestation: Visible corneal oedema with central opacity and conjunctival hyperaemia OD. Normal OS. BCVA (logMAR):Between 8 weeks gestation and 19 weeks gestation: decreased by +1.5 OD (counting fingers), no change OS. Levothyroxine 50 µg/day for 1 week. Corneal hydrops OD resolved in 6 weeks with normalisation of thyroid function. Corneal opacity remains OD. Information Classification: General No of pregnancies: One PKP scheduled postpartum. Author: Gatzioufas et al. Year: 2017 Country: United Kingdom Case report No. of patients identified with KCN: One. No. of eyes identified with KCN: Two. Age at pregnancy (years): 26 No of pregnancies: One BCVA with RGP lenses (logMAR): Between 2 years after DALK (<1 year before pregnancy) and <1 year postpartum: decreased by +0.12 OD, 0 OS. Topography maps: After DALK, OD, and PKP, OS: Irregular astigmatism OD; regular astigmatism OS. <1 year postpartum: recurrence of corneal ectasia OD; mild increased steepness and irregular astigmatism OS. Kmax (D): 3 years prior to delivery: 61 OD; 58 OS. <1 year postpartum: 54 OD; 46 OS. TCT (µm): 3 years prior to delivery: 344 OD; 355 OS. <1 year postpartum: 422 OD; 508 OS. At an unspecified time postpartum: CXL OD.

Iatrogene Keratektasie nach refraktiver Chirurgie – Ursachen, Prophylaxe, Therapie

“…Neben der Neurodermitis werden auch hormonelle Veränderungen, bspw. bei Schilddrüsenaffektionen sowie während der Schwangerschaft diskutiert [24].…”

“…In the latter patients, eye inflammation should be monitored to reduce the tendency to rub the eyes. In addition to neurodermitis, hormonal changes, for example, in thyroid disorders and during pregnancy, are also discussed [24].…”

Ocular surface inflammation and ectatic corneal disorders

“…Since a report of PLE of a 33-year-old during pregnancy with no apparent risk factors in 2008 and increasing reports over the past decade, evidence is mounting linking the progression of PCE to hormonal changes [2]. Research also suggests that thyroid dysfunction coinciding with pregnancy may trigger biomechanical changes that may lead to ectasia [2,47]. Anti-inflammatory drugs can inhibit the progression of CE, decreasing the production of inflammatory cytokines, such as MMPs, TNF-a, IL-1b, IL-6, and IL-8, as well as the production of ROS, thereby decreasing corneal stroma damage [4,54]…”

“…Since a report of PLE of a 33-year-old during pregnancy with no apparent risk factors in 2008 and increasing reports over the past decade, evidence is mounting linking the progression of PCE to hormonal changes [2]. Research also suggests that thyroid dysfunction coinciding with pregnancy may trigger biomechanical changes that may lead to ectasia [2,47].…”

Biochemical and molecular alterations and potential clinical applications of biomarkers in keratoconus

“…Although KC was labeled as a degenerative process for a long period of time,[ 15 ] there is growing evidence in the last decade pointing toward the involvement of more complex pathways and biological factors, including inflammatory,[ 16 17 ] metabolic,[ 18 ] oxidative,[ 19 ] genetic,[ 20 21 ] and hormonal,[ 22 ] among others. [ 23 ] Improvement in techniques such as tear sampling, impression cytology, and analysis of the corneal epithelium and stroma using the growing capabilities in the field of proteomics, metabolomics, transcriptomics, and sequencing has made the above discoveries possible.…”