June 2021
Volume 62, Issue 8
Open Access
ARVO Annual Meeting Abstract  |   June 2021
Risk factors for the development of keratoconus in young adults
Author Affiliations & Notes
  • Gareth Lingham
    Centre for Ophthalmology and Visual Science, The University of Western Australia, Perth, Western Australia, Australia
    Lions Eye Institute, Perth, Western Australia, Australia
  • David A Mackey
    Centre for Ophthalmology and Visual Science, The University of Western Australia, Perth, Western Australia, Australia
    Lions Eye Institute, Perth, Western Australia, Australia
  • Samantha SY Lee
    Centre for Ophthalmology and Visual Science, The University of Western Australia, Perth, Western Australia, Australia
    Lions Eye Institute, Perth, Western Australia, Australia
  • Seyhan Yazar
    Centre for Ophthalmology and Visual Science, The University of Western Australia, Perth, Western Australia, Australia
    Garvan Institute of Medical Research, Darlinghurst, New South Wales, Australia
  • Elsie Chan
    Cornea Unit, Royal Victorian Eye and Ear Hospital, East Melbourne, Victoria, Australia
    Centre for Eye Research Australia, University of Melbourne, Melbourne, Victoria, Australia
  • Elaine Chong
    Royal Victorian Eye and Ear Hospital, East Melbourne, Victoria, Australia
    Cornea Unit, Royal Victorian Eye and Ear Hospital, East Melbourne, Victoria, Australia
  • Footnotes
    Commercial Relationships   Gareth Lingham, None; David Mackey, None; Samantha Lee, None; Seyhan Yazar, None; Elsie Chan, None; Elaine Chong, None
  • Footnotes
    Support  National Health and Medical Research Council (1021105, 1121979), Lions Eye Institute, the Australian Foundation for the Prevention of Blindness, Alcon Research Institute, Ophthalmic Research Institute of Australia (ORIA) and Telethon
Investigative Ophthalmology & Visual Science June 2021, Vol.62, 784. doi:
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    • Get Citation

      Gareth Lingham, David A Mackey, Samantha SY Lee, Seyhan Yazar, Elsie Chan, Elaine Chong; Risk factors for the development of keratoconus in young adults. Invest. Ophthalmol. Vis. Sci. 2021;62(8):784.

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      © ARVO (1962-2015); The Authors (2016-present)

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Abstract

Purpose : To report the incidence and investigate risk factors for the development of keratoconus in a young adult cohort with consecutive Scheimpflug imaging over an 8-year period.

Methods : Participants of the Raine Study generation 2 (Gen2) birth cohort underwent an eye examination at the 20-year (age range 19-22 years) and 28-year follow-ups. Scheimpflug imaging (Pentacam, Oculus, Wetzlar, Germany) was performed at each follow-up. Keratoconus was defined as a Belin/Ambrósio Enhanced Ectasia Display D (BAD-D) score >2.6 in either eye. Data from the worst eye was used for analysis, except for conjunctival ultraviolet autofluorescence (CUVAF, a marker of ocular sun exposure) data where the sum area of both eyes was used. Participants were excluded if they had keratoconus at the 20-year follow-up, had a history of significant eye trauma, wore orthokeratology lenses or did not have Scheimpflug imaging at both follow-ups. Logistic regression was used to investigate potential risk factors for keratoconus incidence over 8 years of follow-up.

Results : Of the 1295 participants who had Scheimpflug imaging at the 20-year follow-up, 685 (53%) had Scheimpflug imaging at the 28-year follow-up and 677 (52%) were eligible for analysis (52% female). There were 20 (3.0%) new cases of keratoconus. The mean (range) worst eye BAD-D score in the incident keratoconus group was 1.70 (0.20 to 2.57) and 3.45 (2.63 to 6.15) at the 20- and 28-year follow-ups, respectively. Keratoconus incidence was not associated with spherical refraction, visual acuity or self-reported history of asthma, eczema or asthma (p>0.05) on univariable analysis. Greater astigmatism, steeper corneal curvature and a thinner central corneal at the 20-year follow-up were associated with higher risk of keratoconus, but we focused on the BAD-D score as a derivative of these variables. In a multivariable model including sex, CUVAF area and BAD-D score at the 20-year follow-up, male sex (odds ratio [OR]=3.84, 95% confidence interval [95%CI]: 1.30, 1.1.29) and higher BAD-D score (OR=14.7, 95%CI: 5.93, 36.6), but not CUVAF area (OR=0.98, 95%CI: 0.96, 1.00), were significantly associated with higher risk of keratoconus.

Conclusions : The incidence of keratoconus was 3% over 8 years in this, predominantly Caucasian, young adult cohort in Perth, Australia. Sex and BAD-D score at the 20-year follow-up were significantly associated with greater risk of keratoconus.

This is a 2021 ARVO Annual Meeting abstract.

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