Keratoconus in Down syndrome: Prevalence, risk factors, severity and corneal tomographic characteristics
Background This study investigated the prevalence, risk factors and severity of corneal tomographic features of keratoconus in Down syndrome (DS). Additionally, previous studies indicate anomalous corneal features in DS, without keratoconus, this study characterised corneal features in DS without ke...
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| Veröffentlicht in: | Clinical & experimental ophthalmology 2024-01, Vol.52 (1), p.22-30 |
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| creator | Mathan, Joyce J. Gokul, Akilesh Simkin, Samantha K. Meyer, Jay J. McGhee, Charles N. J. |
| description | Background
This study investigated the prevalence, risk factors and severity of corneal tomographic features of keratoconus in Down syndrome (DS). Additionally, previous studies indicate anomalous corneal features in DS, without keratoconus, this study characterised corneal features in DS without keratoconus.
Methods
This prospective observational study included participants with DS ≥10 years old. Keratoconus diagnosis, risk factors and corneal tomographic characteristics were recorded. Participants underwent slit‐lamp biomicroscopy, Scheimpflug corneal tomography, corneal topography and autorefraction. A diagnosis of keratoconus (DS‐KC), suspect keratoconus (DS‐SK) and non‐keratoconus (DS‐NK) was made based on expert review of scans by three fellowship trained anterior segment ophthalmologists. Corneal tomography parameters from one eye of each participant were analysed.
Results
Keratoconus affected 50 (26.3%) of 190 participants, diagnosed by corneal tomography, topography or slit‐lamp signs. Corneal hydrops affected 14.0% of DS‐KC participants. Eye rubbing was a significant risk factor for keratoconus (p = 0.036). 175 (92%) participants could undertake corneal tomography of which tomography assessment alone identified 47 (26.9%) DS‐KC participants, 64 (36.6%) DS‐SK participants and 64 (36.6%) DS‐NK participants. Significant differences (p |
| doi_str_mv | 10.1111/ceo.14316 |
| format | Article |
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This study investigated the prevalence, risk factors and severity of corneal tomographic features of keratoconus in Down syndrome (DS). Additionally, previous studies indicate anomalous corneal features in DS, without keratoconus, this study characterised corneal features in DS without keratoconus.
Methods
This prospective observational study included participants with DS ≥10 years old. Keratoconus diagnosis, risk factors and corneal tomographic characteristics were recorded. Participants underwent slit‐lamp biomicroscopy, Scheimpflug corneal tomography, corneal topography and autorefraction. A diagnosis of keratoconus (DS‐KC), suspect keratoconus (DS‐SK) and non‐keratoconus (DS‐NK) was made based on expert review of scans by three fellowship trained anterior segment ophthalmologists. Corneal tomography parameters from one eye of each participant were analysed.
Results
Keratoconus affected 50 (26.3%) of 190 participants, diagnosed by corneal tomography, topography or slit‐lamp signs. Corneal hydrops affected 14.0% of DS‐KC participants. Eye rubbing was a significant risk factor for keratoconus (p = 0.036). 175 (92%) participants could undertake corneal tomography of which tomography assessment alone identified 47 (26.9%) DS‐KC participants, 64 (36.6%) DS‐SK participants and 64 (36.6%) DS‐NK participants. Significant differences (p < 0.001) were identified when the DS‐KC, DS‐SK and DS‐NK groups were compared in maximum keratometry and posterior elevation at the thinnest point respectively: median (interquartile range) 50.20 (10.30D), 47.60 (1.95D), 46.50 (2.40D); 24.0 (38.00 μm), 10.00 (13.75 μm), 8.00 (6.00 μm). The DS‐SK and DS‐NK cohorts had similar minimum pachymetry, however, had several significantly different parameters among which included greater maximum keratometry, posterior elevation at the thinnest point in the DS‐SK group.
Conclusions
Keratoconus is common in DS. Keratoconus screening with corneal tomography is recommended for early detection.</description><identifier>ISSN: 1442-6404</identifier><identifier>EISSN: 1442-9071</identifier><identifier>DOI: 10.1111/ceo.14316</identifier><identifier>PMID: 37963802</identifier><language>eng</language><publisher>Melbourne: John Wiley & Sons Australia, Ltd</publisher><subject>Child ; Cornea ; Cornea - diagnostic imaging ; Corneal Pachymetry ; corneal tomography ; Corneal Topography - methods ; Down syndrome ; Down Syndrome - complications ; Down Syndrome - diagnosis ; Down Syndrome - epidemiology ; Down's syndrome ; Humans ; Keratoconus ; Keratoconus - complications ; Keratoconus - diagnosis ; Keratoconus - epidemiology ; Prenatal diagnosis ; Prevalence ; Risk Factors ; Tomography ; Topography</subject><ispartof>Clinical & experimental ophthalmology, 2024-01, Vol.52 (1), p.22-30</ispartof><rights>2023 The Authors. published by John Wiley & Sons Australia, Ltd on behalf of Royal Australian and New Zealand College of Ophthalmologists.</rights><rights>2023 The Authors. Clinical & Experimental Ophthalmology published by John Wiley & Sons Australia, Ltd on behalf of Royal Australian and New Zealand College of Ophthalmologists.</rights><rights>2023. This article is published under http://creativecommons.org/licenses/by-nc/4.0/ (the “License”). Notwithstanding the ProQuest Terms and Conditions, you may use this content in accordance with the terms of the License.</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><cites>FETCH-LOGICAL-c3486-10be5438774e89e5db503dbc198e3249365b52348a04be33ebc750caa45d6e3a3</cites><orcidid>0000-0001-5582-0338 ; 0000-0001-7048-0706 ; 0000-0003-0643-9420 ; 0000-0002-4487-0636</orcidid></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://onlinelibrary.wiley.com/doi/pdf/10.1111%2Fceo.14316$$EPDF$$P50$$Gwiley$$Hfree_for_read</linktopdf><linktohtml>$$Uhttps://onlinelibrary.wiley.com/doi/full/10.1111%2Fceo.14316$$EHTML$$P50$$Gwiley$$Hfree_for_read</linktohtml><link.rule.ids>314,776,780,1411,27903,27904,45553,45554</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/37963802$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Mathan, Joyce J.</creatorcontrib><creatorcontrib>Gokul, Akilesh</creatorcontrib><creatorcontrib>Simkin, Samantha K.</creatorcontrib><creatorcontrib>Meyer, Jay J.</creatorcontrib><creatorcontrib>McGhee, Charles N. J.</creatorcontrib><title>Keratoconus in Down syndrome: Prevalence, risk factors, severity and corneal tomographic characteristics</title><title>Clinical & experimental ophthalmology</title><addtitle>Clin Exp Ophthalmol</addtitle><description>Background
This study investigated the prevalence, risk factors and severity of corneal tomographic features of keratoconus in Down syndrome (DS). Additionally, previous studies indicate anomalous corneal features in DS, without keratoconus, this study characterised corneal features in DS without keratoconus.
Methods
This prospective observational study included participants with DS ≥10 years old. Keratoconus diagnosis, risk factors and corneal tomographic characteristics were recorded. Participants underwent slit‐lamp biomicroscopy, Scheimpflug corneal tomography, corneal topography and autorefraction. A diagnosis of keratoconus (DS‐KC), suspect keratoconus (DS‐SK) and non‐keratoconus (DS‐NK) was made based on expert review of scans by three fellowship trained anterior segment ophthalmologists. Corneal tomography parameters from one eye of each participant were analysed.
Results
Keratoconus affected 50 (26.3%) of 190 participants, diagnosed by corneal tomography, topography or slit‐lamp signs. Corneal hydrops affected 14.0% of DS‐KC participants. Eye rubbing was a significant risk factor for keratoconus (p = 0.036). 175 (92%) participants could undertake corneal tomography of which tomography assessment alone identified 47 (26.9%) DS‐KC participants, 64 (36.6%) DS‐SK participants and 64 (36.6%) DS‐NK participants. Significant differences (p < 0.001) were identified when the DS‐KC, DS‐SK and DS‐NK groups were compared in maximum keratometry and posterior elevation at the thinnest point respectively: median (interquartile range) 50.20 (10.30D), 47.60 (1.95D), 46.50 (2.40D); 24.0 (38.00 μm), 10.00 (13.75 μm), 8.00 (6.00 μm). The DS‐SK and DS‐NK cohorts had similar minimum pachymetry, however, had several significantly different parameters among which included greater maximum keratometry, posterior elevation at the thinnest point in the DS‐SK group.
Conclusions
Keratoconus is common in DS. Keratoconus screening with corneal tomography is recommended for early detection.</description><subject>Child</subject><subject>Cornea</subject><subject>Cornea - diagnostic imaging</subject><subject>Corneal Pachymetry</subject><subject>corneal tomography</subject><subject>Corneal Topography - methods</subject><subject>Down syndrome</subject><subject>Down Syndrome - complications</subject><subject>Down Syndrome - diagnosis</subject><subject>Down Syndrome - epidemiology</subject><subject>Down's syndrome</subject><subject>Humans</subject><subject>Keratoconus</subject><subject>Keratoconus - complications</subject><subject>Keratoconus - diagnosis</subject><subject>Keratoconus - epidemiology</subject><subject>Prenatal diagnosis</subject><subject>Prevalence</subject><subject>Risk Factors</subject><subject>Tomography</subject><subject>Topography</subject><issn>1442-6404</issn><issn>1442-9071</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2024</creationdate><recordtype>article</recordtype><sourceid>24P</sourceid><sourceid>WIN</sourceid><sourceid>EIF</sourceid><recordid>eNp10LtOwzAUBmALgSi3gRdAllhA6sWOncRmQ-UqKpUBZstxTmkgsYudFPXtMbQwIOHlePj065wfoWNKhjS-kQE3pJzRbAvtUc6TgSQ53d78M054D-2H8EoISROW7aIey2XGBEn20PwBvG6dcbYLuLL4yn1YHFa29K6BC_zoYalrsAb62FfhDc-0aZ0PfRxgCb5qV1jbEhvnLegat65xL14v5pXBZq59xBGFtjLhEO3MdB3gaDMP0PPN9dP4bjCZ3t6PLycDw7jIBpQUkHIm8pyDkJCWRUpYWRgqBbCES5alRTyCC014AYxBYfKUGK15WmbANDtAZ-vchXfvHYRWNVUwUNfaguuCSoQkLKM5lZGe_qGvrvM2bqcSmVCZCyJEVOdrZbwLwcNMLXzVaL9SlKiv-lWsX33XH-3JJrErGih_5U_fEYzW4KOqYfV_khpfT9eRn0XojtA</recordid><startdate>202401</startdate><enddate>202401</enddate><creator>Mathan, Joyce J.</creator><creator>Gokul, Akilesh</creator><creator>Simkin, Samantha K.</creator><creator>Meyer, Jay J.</creator><creator>McGhee, Charles N. J.</creator><general>John Wiley & Sons Australia, Ltd</general><general>Wiley Subscription Services, Inc</general><scope>24P</scope><scope>WIN</scope><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7TK</scope><scope>K9.</scope><scope>7X8</scope><orcidid>https://orcid.org/0000-0001-5582-0338</orcidid><orcidid>https://orcid.org/0000-0001-7048-0706</orcidid><orcidid>https://orcid.org/0000-0003-0643-9420</orcidid><orcidid>https://orcid.org/0000-0002-4487-0636</orcidid></search><sort><creationdate>202401</creationdate><title>Keratoconus in Down syndrome: Prevalence, risk factors, severity and corneal tomographic characteristics</title><author>Mathan, Joyce J. ; Gokul, Akilesh ; Simkin, Samantha K. ; Meyer, Jay J. ; McGhee, Charles N. J.</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c3486-10be5438774e89e5db503dbc198e3249365b52348a04be33ebc750caa45d6e3a3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2024</creationdate><topic>Child</topic><topic>Cornea</topic><topic>Cornea - diagnostic imaging</topic><topic>Corneal Pachymetry</topic><topic>corneal tomography</topic><topic>Corneal Topography - methods</topic><topic>Down syndrome</topic><topic>Down Syndrome - complications</topic><topic>Down Syndrome - diagnosis</topic><topic>Down Syndrome - epidemiology</topic><topic>Down's syndrome</topic><topic>Humans</topic><topic>Keratoconus</topic><topic>Keratoconus - complications</topic><topic>Keratoconus - diagnosis</topic><topic>Keratoconus - epidemiology</topic><topic>Prenatal diagnosis</topic><topic>Prevalence</topic><topic>Risk Factors</topic><topic>Tomography</topic><topic>Topography</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Mathan, Joyce J.</creatorcontrib><creatorcontrib>Gokul, Akilesh</creatorcontrib><creatorcontrib>Simkin, Samantha K.</creatorcontrib><creatorcontrib>Meyer, Jay J.</creatorcontrib><creatorcontrib>McGhee, Charles N. J.</creatorcontrib><collection>Wiley Online Library Open Access</collection><collection>Wiley Online Library Free Content</collection><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>Neurosciences Abstracts</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>MEDLINE - Academic</collection><jtitle>Clinical & experimental ophthalmology</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Mathan, Joyce J.</au><au>Gokul, Akilesh</au><au>Simkin, Samantha K.</au><au>Meyer, Jay J.</au><au>McGhee, Charles N. J.</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Keratoconus in Down syndrome: Prevalence, risk factors, severity and corneal tomographic characteristics</atitle><jtitle>Clinical & experimental ophthalmology</jtitle><addtitle>Clin Exp Ophthalmol</addtitle><date>2024-01</date><risdate>2024</risdate><volume>52</volume><issue>1</issue><spage>22</spage><epage>30</epage><pages>22-30</pages><issn>1442-6404</issn><eissn>1442-9071</eissn><abstract>Background
This study investigated the prevalence, risk factors and severity of corneal tomographic features of keratoconus in Down syndrome (DS). Additionally, previous studies indicate anomalous corneal features in DS, without keratoconus, this study characterised corneal features in DS without keratoconus.
Methods
This prospective observational study included participants with DS ≥10 years old. Keratoconus diagnosis, risk factors and corneal tomographic characteristics were recorded. Participants underwent slit‐lamp biomicroscopy, Scheimpflug corneal tomography, corneal topography and autorefraction. A diagnosis of keratoconus (DS‐KC), suspect keratoconus (DS‐SK) and non‐keratoconus (DS‐NK) was made based on expert review of scans by three fellowship trained anterior segment ophthalmologists. Corneal tomography parameters from one eye of each participant were analysed.
Results
Keratoconus affected 50 (26.3%) of 190 participants, diagnosed by corneal tomography, topography or slit‐lamp signs. Corneal hydrops affected 14.0% of DS‐KC participants. Eye rubbing was a significant risk factor for keratoconus (p = 0.036). 175 (92%) participants could undertake corneal tomography of which tomography assessment alone identified 47 (26.9%) DS‐KC participants, 64 (36.6%) DS‐SK participants and 64 (36.6%) DS‐NK participants. Significant differences (p < 0.001) were identified when the DS‐KC, DS‐SK and DS‐NK groups were compared in maximum keratometry and posterior elevation at the thinnest point respectively: median (interquartile range) 50.20 (10.30D), 47.60 (1.95D), 46.50 (2.40D); 24.0 (38.00 μm), 10.00 (13.75 μm), 8.00 (6.00 μm). The DS‐SK and DS‐NK cohorts had similar minimum pachymetry, however, had several significantly different parameters among which included greater maximum keratometry, posterior elevation at the thinnest point in the DS‐SK group.
Conclusions
Keratoconus is common in DS. Keratoconus screening with corneal tomography is recommended for early detection.</abstract><cop>Melbourne</cop><pub>John Wiley & Sons Australia, Ltd</pub><pmid>37963802</pmid><doi>10.1111/ceo.14316</doi><tpages>9</tpages><orcidid>https://orcid.org/0000-0001-5582-0338</orcidid><orcidid>https://orcid.org/0000-0001-7048-0706</orcidid><orcidid>https://orcid.org/0000-0003-0643-9420</orcidid><orcidid>https://orcid.org/0000-0002-4487-0636</orcidid><oa>free_for_read</oa></addata></record> |
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| source | Wiley Online Library - AutoHoldings Journals; MEDLINE |
| subjects | Child Cornea Cornea - diagnostic imaging Corneal Pachymetry corneal tomography Corneal Topography - methods Down syndrome Down Syndrome - complications Down Syndrome - diagnosis Down Syndrome - epidemiology Down's syndrome Humans Keratoconus Keratoconus - complications Keratoconus - diagnosis Keratoconus - epidemiology Prenatal diagnosis Prevalence Risk Factors Tomography Topography |
| title | Keratoconus in Down syndrome: Prevalence, risk factors, severity and corneal tomographic characteristics |
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