Department of Ophthalmology, Eye Research Center, Khatam-al-Anbia Eye Center, Mashhad University of Medical Sciences, Mashhad, Iran.
Cornea. 2023 Mar 1;42(3):308-312. doi: 10.1097/ICO.0000000000003055. Epub 2022 May 12.
The aim of this study was to evaluate the corneal higher-order aberrations (HOAs) in first-degree relatives of patients with keratoconus (KCN) and compare with the normal population.
In this prospective comparative study, 210 eyes from 105 family members of 28 patients with KCN and 210 normal eyes of 105 controls were enrolled. In each eye, corneal topography, tomography, and aberrometry were performed and compared between the 2 groups.
This study included 61 female (58.1%) and 44 male participants (41.9%) and 105 age-matched and sex-matched controls with normal topographic cornea. In 14 of 105 first-degree relatives (13.33%) of patients with KCN, KCN was diagnosed with a male preponderance (71.5% male, 28.5% female). Tomographic indices and irregularity indices in 3 and 5 mm zone in Orbscan were significantly higher in the relative group. In addition, other irregularity indices of TMS-4 topography including surface regularity index, surface asymmetry index, difference sector index, SDP, and irregular astigmatism index were significantly higher in family members of patients with KCN. The most prevalent topographic pattern in the control group was the symmetric bowtie (57.1%) and in the relative group was the asymmetric bowtie (39.5%). In addition, significantly thinnest corneal pachymetry was detected in the relative group. Root mean square of all HOAs including vertical trefoil, vertical coma, horizontal coma, horizontal trefoil, quadrifoil, and fourth-order spherical aberrations were significantly greater in the relative group than controls.
Owing to the high prevalence of undiagnosed KCN susceptibility in family members with KCN, keratorefractive surgery should be considered cautiously in these individuals. In addition, comprehensive preoperative examination should be considered to detect subtle topographic and HOAs in these individuals.
本研究旨在评估圆锥角膜（KCN）患者一级亲属的角膜高阶像差（HOAs），并与正常人群进行比较。
在这项前瞻性对照研究中，共纳入 28 例 KCN 患者的 105 名一级亲属的 210 只眼和 105 名正常对照者的 210 只眼。对两组患者的每只眼均进行角膜地形图、角膜断层扫描和像差检查，并进行比较。
本研究共纳入 61 名女性（58.1%）和 44 名男性（41.9%）参与者，以及 105 名年龄和性别匹配的正常角膜地形图对照者。在 105 名 KCN 患者的一级亲属中，有 14 名（13.33%）诊断为 KCN，且男性发病率较高（71.5%为男性，28.5%为女性）。Orbscan 3 和 5mm 区的角膜断层扫描指数和不规则指数在亲属组中显著较高。此外，TMS-4 地形图的其他不规则指数，包括表面规则指数、表面非对称指数、差异扇区指数、SDP 和不规则散光指数，在 KCN 患者的亲属中也显著较高。对照组中最常见的角膜地形图模式为对称蝶形（57.1%），而在亲属组中为不对称蝶形（39.5%）。此外，在亲属组中还检测到角膜最薄的中央角膜厚度。在亲属组中，所有高阶像差（包括垂直三叶、垂直彗差、水平彗差、水平三叶、四叶和四阶球差）的均方根均显著大于对照组。
由于 KCN 患者一级亲属中有未确诊的 KCN 易感性的高患病率，因此应谨慎考虑对这些个体进行角膜屈光手术。此外，应考虑进行全面的术前检查，以在这些个体中检测到细微的角膜地形图和高阶像差。
