Purchase this article with an account.
Enrique Graue Wiechers, Jazmin Lucero Pedro Aguilar, Andrew G Olivo Payne, Arturo J Ramirez-Miranda, Alejandro Navas, Aida Jimenez-Corona, Enrique O Graue; KERATOCONUS IN CHILDREN: LONG TERM FOLLOW-UP. Invest. Ophthalmol. Vis. Sci. 2014;55(13):1583.
Download citation file:
© ARVO (1962-2015); The Authors (2016-present)
To determine visual outcomes, disease progression, need for surgery in patients diagnosed with keratoconus (KC) before 18 years.
Retrospective case series. All patients with tomographic diagnosis of keratoconus (Pentacam HR ,Oculus, Germany) younger than 18 years of age were identified, from July 2007 to May 2013 were identified. The quantitative tomographic parameters were compared and tested as predictive factors for KC progression. Additionally, family history, allergic conjunctivitis, refraction, best-corrected visual acuity, keratoconus grading scale (Amsler-Krumeich stages), co-morbidities, and KC treatment (intracorneal ring segments, corneal cross-linking, keratoplasty) were evaluated. Statiscall analysis was performed with STATA v12. Descriptive statistics were obtained. Poisson regression analysis was done to evaluate the influence of potential markers of progression.
One hundred-thirty four eyes were included in this study. There were 57 (72.2%) males and 22 (27.8%) females. The mean age was 14 + 2.6 years, and the median follow-up period was 33.6 months (range 6-71 months). Only 2 patients (1.49%) had a family history of keratoconus. Of all eyes, 45 were evaluated at stage I keratoconus, 34 at stage II, 9 at stage III, and 46 at stage IV keratoconus. 110 patients (82.1%) had allergic conjunctivitis. Fifty-six (40.2%) eyes enrolled in this study showed progression. Acute hydrops occurred in 17 eyes (12.6%). Twelve eyes (8.2%) were treated by cross-linking, 6 eyes were managed with intracorneal ring segment, 3 patients (2.23%) required lamellar keratoplasty and 33 eyes (21.6%) penetrating keratoplasty, of which 4 eyes (9%) showed corneal graft rejection. Poisson regression analysis revealed that only severity and logMAR at the time of diagnosis was a significant predictor for progression (RR 1.97 CI95% 1.07-362 p=0.03, RR 1.85 CI95% 1.05-3.24 p=0.03
Results indicate that progression of keratoconus occurred in 40.2% of patients.Our findings demonstrated a high percentage of allergic conjunctivitis in children with keratoconus (82.1%). The greater the severity of presentation the more likely it will progress. Greater understanding of such predisposing risk factors may help develop early management strategies to delay or prevent progression of this disease.
This PDF is available to Subscribers Only