Dr. Rajendra Prasad Centre for Ophthalmic Sciences, All India Institute of Medical Sciences, Delhi, India.
Dr. Rajendra Prasad Centre for Ophthalmic Sciences, All India Institute of Medical Sciences, Delhi, India.
Am J Ophthalmol. 2021 May;225:69-75. doi: 10.1016/j.ajo.2020.12.020. Epub 2020 Dec 29.
This study sought to evaluate the demographic profile, clinical features, topographic features, and biomechanical and aberrometric characteristics in pediatric keratoconus (KC).
Cross-sectional study.
Pediatric KC cases <18 years of age were evaluated at a tertiary hospital. Main outcome measurements were demographic profile, clinical features, visual acuity, corneal topography, aberrometry, and biomechanical and confocal microscopy findings.
A total of 116 eyes of 62 consecutive patients were recruited with a mean ± age of 14.7 ± 2.77 years (range: 8-18 years); 46 of 62 (88%) were males; 57 of 62 cases (92%) had bilateral disease; 53 of 116 eyes (46%) had progressive KC; and 9 of 116 eyes (8%) had acute hydrops. Systemic associations were found in 6 of 62 patients (9.7%) and ocular associations in 77 of 116 eyes (66.3%); 68 of 116 eyes (58.6%) had associated vernal keratoconjunctivitis (VKC). Among eyes with VKC, 29 of 68 eyes (46%) were in stage IV KC, versus 25% of eyes with no VKC (P = .004). The mean ± SD refractive spherical equivalent was -4.72 ± 3.32 diopters (D), and refractive astigmatism was 3.69 ± 3.09 D. The mean values of maximum keratometry, thinnest pachymetry, and corneal higher-order aberrations were 60.89 ± 10.9 D, 396.05 ± 95.03 μm, and 1.18 ± 1.2 μm, respectively. Values of corneal hysteresis and corneal resistance factor correlated with the stage of KC (r = -0.26; P = .007).
Pediatric KC was commonly associated with VKC in this cohort. Eyes with VKC had more severe KC than those without VKC. Nearly half of the patients presented with progressive disease. Corneal biomechanical changes correlated well with stage of KC in this pediatric age group.
本研究旨在评估小儿圆锥角膜（KC）的人口统计学特征、临床特征、地形特征以及生物力学和像差特征。
横断面研究。
在一家三级医院评估了年龄<18 岁的小儿 KC 病例。主要的观察指标包括人口统计学特征、临床特征、视力、角膜地形图、像差和生物力学及共焦显微镜检查结果。
共纳入 62 例连续患者的 116 只眼，平均年龄为 14.7 ± 2.77 岁（范围：8-18 岁）；46 例（88%）为男性；57 例（92%）双眼患病；53 只眼（46%）为进展性 KC；9 只眼（8%）为急性水肿。62 例患者中有 6 例（9.7%）存在全身关联，116 只眼中有 77 只（66.3%）存在眼部关联；116 只眼中有 68 只（58.6%）伴有春季角结膜炎（VKC）。在伴有 VKC 的眼中，68 只眼中有 29 只（46%）处于 IV 期 KC，而无 VKC 的眼中有 25%（P=0.004）。平均（±SD）屈光球镜等效值为-4.72 ± 3.32 屈光度（D），屈光性散光为 3.69 ± 3.09 D。最大角膜曲率、最薄角膜厚度和角膜高阶像差的平均值分别为 60.89 ± 10.9 D、396.05 ± 95.03 μm 和 1.18 ± 1.2 μm。角膜滞后量和角膜阻力因子值与 KC 分期相关（r=-0.26；P=0.007）。
在本队列中，小儿 KC 通常与 VKC 相关。伴有 VKC 的眼比不伴有 VKC 的眼的 KC 更严重。近一半的患者表现为进行性疾病。在这个小儿年龄段，角膜生物力学变化与 KC 分期密切相关。
