The role of environment in the pathogenesis of keratoconus

Magalhães, Otávio de Azevedo; Gonçalves, Mauro Cabral; Gatinel, Damien

doi:10.1097/icu.0000000000000764

Cited by 13 publications

(3 citation statements)

References 73 publications

(103 reference statements)

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“…Although the true etiology of KC is not explored yet, a number of pathogenic factors such as atopy, genetic predisposition, environmental factors, oxidative stress, hormonal status are believed to play role and its association with some systemic conditions such as connective tissue diseases, Ehlers Danlos syndrome and pregnancy [11,12] is well-established. Contrary to its former categorization as a non-inflammatory disease, recent studies showed that KC may be associated with inflammation.…”

Section: Discussionmentioning

confidence: 99%

Pentacam corneal topography and densitometry features of PCOS patients

2023

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Background To evaluate corneal topography and densitometry features in patients with polycystic ovary syndrome (PCOS) and compare them with healthy individuals. Methods 53 eyes of 53 female patients diagnosed with PCOS and 53 eyes of 53 age-matched female volunteers were analyzed in the study. In addition to the detailed ophthalmological and gynecological examination, anterior segment analysis was performed using Pentacam. A complete analysis of aberrometric, keratometric, topometric, and, densitometric values between the groups was performed, and the results were outlined. Results According to the results, although Kmax-front, Kmean-front, ISV, IVA, IHA, BAD_D and PI-Avg values were slightly higher in PCOS group along with a slight thinning in the thinnest location, there was no statistically significant difference between the groups. Moreover, correlation analysis between PCOS clinical parameters and keratometric/topometric/aberrometric data were found to be almost normal. Yet, when Pentacam tomography maps of all cases are examined in detail, mild ectatic changes were observed in 5 cases in PCOS group. Furthermore, a significant increase in thickness across all densitometry values except anterior (10–12 mm), central (10–12 mm), and total (10–12 mm) was found in PCOS group. Conclusions Our study showed that an intensification of corneal densitometry values and various changes in keratometry data implying ectasia can be observed in patients with PCOS. Prospective studies with larger patient series are needed to reveal any potential relationship between PCOS and corneal abnormalities.

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Section: Discussionmentioning

confidence: 99%

Pentacam corneal topography and densitometry features of PCOS patients

2023

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“…Keratoconus (KC) is a bilateral ectatic corneal disorder characterized by progressive thinning and steepening; the etiology of the disease is unknown, but there are wellrecognized risk factors, such as eye rubbing [1], familiarity and inflammation [2][3][4]. Usually, KC is diagnosed in the adolescence and progresses in the first 3-4 decades of life [5].…”

Section: Introductionmentioning

confidence: 99%

Transepithelial Iontophoresis-Assisted Cross Linking for Progressive Keratoconus: Up to 7 Years of Follow Up

Vinciguerra

Legrottaglie

Tredici

et al. 2022

JCM

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Purpose: To report long-term clinical results of transepithelial cross-linking with iontophoresis (I-CXL) for progressive keratoconus (KC). Methods: Nineteen eyes of 19 patients treated with I-CXL for progressive keratoconus were included in this prospective clinical study. Preoperatively and in all available follow ups (6, 12, 24, 36, 48, 60, 72 and 84 months), the following parameters were measured. Corrected distance visual acuity (CDVA), spherical equivalent and cylinder refraction, corneal topography and aberrometry (Costruzione Strumenti Oftalmici (C.S.O.), Florence, Italy), Scheimpflug tomography (OCULUS Optikgeräte GmbH; Wetzlar, Germany). Definition of progression after I-CXL was 2/3 of the following criteria: increase of “A” value, increase of “B” value, decrease of minimal thickness evaluated with the ABCD progression display above 95% confidence interval for post-CXL population when compared to the scan 12 months post-op. Results: The mean follow-up time of included patients was 63 months (range 12 to 84 months, 5 patients reached 84 months). The general linear model showed no significant change over time in CDVA, Maximum Keratometry, Thinnest point, and A, B, C values of the Belin Progression Display (p > 0.05). Conversely, comatic and high order aberrations decreased significantly over time (both p =< 0.001). Five cases (26.31%) showed significant progression after a mean of 55 months (range 36–72) of follow up. Conclusion: Our study shows the ability of I-CXL to slow down KC progression in the majority of included patients, improving high order and comatic aberrations. A 26% progression rate was reported.

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“…Keratoconus is a highly prevalent disease; however the pathophysiology is not yet fully understood. In recent papers, we proposed a primarily mechanical cause 3 – 9 , with eye rubbing playing a fundamental role, with other known risk factors (biochemical, genetic, environmental) likely being associated with eye rubbing.…”

Section: Introductionmentioning

confidence: 99%

Quantitative interocular comparison of total corneal surface area and corneal diameter in patients with highly asymmetric keratoconus

Crahay

Debellemanière

Tobalem

et al. 2022

Sci Rep

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Keratoconus is a progressive corneal disorder which is frequently asymmetric. The aetiology of keratoconus remains unclear, and the concept of keratoconus as an ectatic disorder has been challenged recently. We carried out a retrospective study in 160 eyes of 80 patients, to evaluate and compare interocular differences in corneal diameter and surface area in patients with unilateral or highly asymmetric keratoconus (UHAKC). Calculations were performed using raw topographic elevation data derived from topographic measurements using Orbscan II, and we extrapolated surface areas up to measured corneal diameter. We also evaluated inter-eye correlation, and correlation between corneal surface area, corneal diameter and keratoconus severity. Our results showed a statistically significant but not clinically important greater corneal diameter (12.14 mm and 12.17 mm; p = 0.04), and corneal surface area (paired t-test, p < 0.0001; p = 0.0009 respectively) in more affected eyes. Inter-eye comparison revealed corneal diameter, anterior chamber depth, and corneal surface area were strongly correlated between eyes. Corneal surface area remained strongly correlated, and Bland–Altman analysis also showed strong inter-ocular agreement. Our results show that in patients with UHAKC the interocular difference in corneal diameter and corneal surface area is clinically insignificant, and are consistent with a redistribution, rather than increase, of corneal surface area with keratoconus progression.

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The role of environment in the pathogenesis of keratoconus

Cited by 13 publications

References 73 publications

Pentacam corneal topography and densitometry features of PCOS patients

Pentacam corneal topography and densitometry features of PCOS patients

Transepithelial Iontophoresis-Assisted Cross Linking for Progressive Keratoconus: Up to 7 Years of Follow Up

Quantitative interocular comparison of total corneal surface area and corneal diameter in patients with highly asymmetric keratoconus

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