The Dundee University Scottish Keratoconus study: demographics, corneal signs, associated diseases, and eye rubbing

Abstract

Aim To investigate and correlate the corneal, refractive, topographic and familial characteristics of a large cohort with keratoconus. Methods Prospective observational study of 200 consecutive patients presenting with keratoconus during the 4 year-period 1997-2000. Subjects were examined at enrolment and at a final review. Data were collected on demographic characteristics, referral route, symptoms, refractive correction, eye rubbing, family history, medical history, slit-lamp biomicroscopic corneal signs, and computerized corneal topography. Results Mean age at enrolment was 30.9710.4 (range, 12.2-72) years (N ¼ 200, 62.5% male, 93% white Caucasian) with a 5% family history of keratoconus. Atopic diseases included asthma (23%), eczema (14%), and hay fever (30%). Only 9% wore contact lenses before referral. Mean follow-up was 1004 days 7282 (range, 390-1335) and 9.778.9 (range, 1.1-60) years from diagnosis. The mean simulated K1 corneal power at enrolment was 51.7475.36 (range, 42.59-67.32) D and 88.5% exhibited bilateral keratoconus. Fifty-three (15%) topographically confirmed cones exhibited no clinical corneal signs at presentation. At enrollment, 56% had a pachymetry o0.480 mm increasing to 77% at final review. Forty-eight percent of subjects reported significant eye rubbing and there was a highly statistically significant difference (two sample t-test P ¼ 0.018) between keratoconus and control groups. TMS-2 axial corneal power was strongly associated with corneal scarring and age at diagnosis. The size of the scarring effect was 2.2 D (95% confidence interval (CI) 1.34, 3.06). Conclusions This study provides an overview of a large population with keratoconus highlighting presenting features and clinical and topographic progression over a 4 year-period.

The Epidemiology and Etiology of Keratoconus

“…The preponderance of men over women has been noted in the most recent studies. 20,[30][31][32][33][34][35][36] Georgiou et al 37 reported a difference of 2.6 times higher in men than women. Some, mainly older studies, have not found differences in the prevalence between genders.…”

Keratoconus und dessen Behandlung mit Hornhautvernetzung und Kontaktlinsen: ein Überblick

“…Diese sind die meist verwendete CL-Type bei KC. Zwei große Studien [9,11] zeigten die häufige Verwendung rigider gaspermeabler CL. Eine Reihe von Linsen-Designs sind verfügbar und bringen einen zufriedenstellenden Tragekomfort.…”

Aberrometric Outcomes of Intrastromal Corneal Ring Segment (KeraRing 355) Implantation Using PocketMaker Microkeratome in Patients with Keratoconus

“…Initiating in puberty, Keratoconus (KCN) often progresses until fourth decade of life [2]. Affecting all ethnic groups equally, KCN usually causes high myopia and irregular astigmatism which results in poor quality of vision [2,3]. Based on disease severity, many treatment modalities exist including glasses and contact lenses for mild to moderate disease [2][3][4] while corneal graft preserved for more advanced disease [5].…”

“…Affecting all ethnic groups equally, KCN usually causes high myopia and irregular astigmatism which results in poor quality of vision [2,3]. Based on disease severity, many treatment modalities exist including glasses and contact lenses for mild to moderate disease [2][3][4] while corneal graft preserved for more advanced disease [5]. High costs, need to long follow-ups, long periods for visual rehabilitation, risks of graft rejection or infection, wound dehiscence and suture-related problems make corneal grafts preserved for the last therapeutic choice by many ophthalmologists [6].…”