The Association Between Keratoconus and Mitral Valve Prolapse: A Meta-Analysis

Abstract

<jats:sec> <jats:title>Objective:</jats:title> <jats:p>The debate pertaining to the association between Keratoconus (KC) and Mitral Valve Prolapse (MVP) continues to occur among physicians. The results of cross-sectional studies attempting to present the co-existing prevalence of these two diseases remain indeterminate. We compiled the first meta-analysis to determine the pattern of prevalence between the two diseases.</jats:p> </jats:sec> <jats:sec> <jats:title>Methods:</jats:title> <jats:p>Two separate literature searches for cross-sectional studies were performed for this metaanalysis. The first search encompassed finding literature comparing the prevalence of KC between patients with MVP and a control group. The second search pertained to finding studies comparing the prevalence of MVP patients with KC and a control group.</jats:p> </jats:sec> <jats:sec> <jats:title>Results:</jats:title> <jats:p>Six studies reported the prevalence of MVP in patients with KC and a control group. The prevalence was 41.6% in patients with KC and 11.5% in patients without KC (OR = 7.06 [95% CI = 2.41-20.64]). There was a significant heterogeneity among the studies (I2 = 84%). Two studies showed the prevalence of KC in patients with MVP and a control group. The prevalence was 17.0% in patients with KC and 2.9% in the control group (OR = 5.07 [95% CI = 1.08-23.83]). There was no heterogeneity within the analysis (I2 = 0%).</jats:p> </jats:sec> <jats:sec> <jats:title>Conclusion:</jats:title> <jats:p>There is a statistically significant co-existing prevalence between MVP and KC. Patients with KC are more likely to present with MVP, and patients with MVP are more likely to present with KC.</jats:p> </jats:sec>

Systemic Associations with Keratoconus

“…A population-based matched case–control study in Taiwan did not find a significant difference in rates of MVP between keratoconus and control subject groups [ 23 ]. However, a meta-analysis of six studies reporting the prevalence of MVP in keratoconus populations, and two studies reporting the prevalence of keratoconus in the MVP population, found a significant association between MVP and keratoconus [ 105 ]. Further, a retrospective nationwide matched-cohort study in Taiwan examining 4488 keratoconus patients proposed recommendations for screening keratoconus patients for MVP after finding a 1.77 times higher incidence of MVP in keratoconus patients 40 years and older and a 1.49 times higher incidence of MVP in female keratoconus patients compared to controls [ 106 ].…”

Reduced Retinal Blood Vessel Densities Measured by Optical Coherence Tomography Angiography in Keratoconus Patients Are Negatively Correlated with Keratoconus Severity

“…It has been hypothesized that elevated levels of proinflammatory cytokines also affect the cardiovascular system. An association between KC and mitral valve prolapse has been assumed since the 1980s, and a recent meta-analysis, including six studies, indeed found a significant coexisting prevalence between KC and mitral valve prolapse [75]. Back difference elevation measured by Scheimpflug corneal tomography was found to be significantly higher in patients with aortic aneurysm, suggesting a link between aortic aneurysm and KC [76].…”