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Chris Hodge, Ashima Aggarwala, Mario D'Souza, Gerard Sutton, Jingjing You; Gender could play an important part in the onset of keratoconus-insights from characterizing an Australia keratoconus cohort. Invest. Ophthalmol. Vis. Sci. 2019;60(9):6505.
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© ARVO (1962-2015); The Authors (2016-present)
Keratoconus is a complex disease associated with both environmental and genetic risk factors.1 Previous gene profiling studies demonstrated distinct gene expression patterns between male and female corneal epithelium.2,3 This study focused on an Australia cohort to examine the characteristics of keratoconus in Australia population, and further analyse the effect of gender in the disease.
The study was retrospective in nature and approved by the University of Sydney Human Research Ethics Committee (HERC 2013/1041). Data included gender, ethnicity, history of atopy, history of eye rubbing, family history of keratoconus, age at diagnosis, presence of bio-microscopic slit lamp signs, corneal topography for each eye were collected and analysed using univariate and multivariate analysis. A p value of 0.05 is used as the significant threshold in this study.
The medical records of 124 keratoconus patients were reviewed and analysed, of which 63.7% were male and 36.3% were female. Gender was significantly associated with eye rubbing in both uni- and multi-variate analysis (p<0.05). Eye rubbing and atopy were found to be significantly associated with an earlier mean age at diagnosis (p=0.002). Over a quarter of patients (26.6%) described a prior diagnosis of atopy, which was significantly associated with an earlier mean age at diagnosis, the presence of corneal scarring on slit lamp examination, and a negative association with pachymetry (p <0.05).
Our findings suggested that eye rubbing is significantly presented with higher numbers of male patients, which has not been previously described and may be due to the different gene profiles between male and female corneas.2,3 Eye rubbing and atopy may be contributed to different causes of keratoconus. These results suggest that monitoring eye rubbing may be particularly important for male children. Further large sample size is essential to validate these findings. Nevertheless, our findings provide strong evidence that both clinical and molecular based keratoconus research may need to incorporate gender different into study plan and analysis.
This abstract was presented at the 2019 ARVO Annual Meeting, held in Vancouver, Canada, April 28 - May 2, 2019.
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