Abstract
Purpose :
To evaluate the prevalence of keratoconus identified using Scheimpflug imaging in a pediatric population in Riyadh, Saudi Arabia (KSA).
Methods :
This prospective, cross-sectional, observational, multicenter study collected data from pediatric patients from 6 and 21 years of age who were seen at multiple locations within KSA. All subjects had bilateral corneal evaluations performed using a rotational Scheimpflug system and evaluated by two masked reviewers. Two masked ophthalmologists subspecialized in cornea and refractive surgery using subjective pattern analysis combined with objective metrics (maximum keratometry, regional corneal thickness values, and BAD-D scores, among others). Cohen's kappa coefficient (κ) was used to qualitatively analyze the inter-examiner agreement.
Results :
There were 522 patients (1044 eyes) evaluated, with an average age of 16.8±4.2 years (range 6 to 21 years). There was discrepancy in diagnosis between the examiners in 9/522 patients (1.7%). Keratoconus prevalence was 5.56% for examiner 1 and 3.83% for examiner 2. The κ was 0.81, indicating “near perfect” or “excellent” agreement. The nine disputed cases were then jointly evaluated in order to reach a consensus. Final keratoconus prevalence was 4.79% (95% CI: 2.96 to 6.62), or 1:21 patients.
Conclusions :
The prevalence of keratoconus among pediatric patients in the KSA is considerably higher than numbers previously reported. This increase might be due to geographical variations in disease prevalence, or due to the ability of screening technology to detect undiagnosed keratoconus with greater accuracy.
This is an abstract that was submitted for the 2018 ARVO Annual Meeting, held in Honolulu, Hawaii, April 29 - May 3, 2018.