Lalgudi Vaitheeswaran G, Shetty Rohit, Nischal Kanwal K, Ziai Setareh, Koaik Mona, Sethu Swaminathan
Department of Cornea, External Disease and Refractive Surgery, University of Ottawa Eye Institute, The Ottawa Hospital, Ottawa, ON, Canada.
Department of Cornea and Refractive Surgery, Narayana Nethralaya, Bengaluru, Karnataka, India.
Saudi J Ophthalmol. 2022 Apr 9;36(1):7-16. doi: 10.4103/SJOPT.SJOPT_203_21. eCollection 2022 Jan-Mar.
Keratoconus (KC) is a complex multifactorial corneal ectatic disorder, with disease onset commonly in the second-third decades significantly affecting quantity, quality of vision, and quality of life. Several pathways and factors such as eye rubbing, inflammatory, oxidative, metabolic, genetic, and hormonal among others have been studied in the last two decades. However, the management of KC is still based on a few "one-size fits all" approaches and is predominantly guided by topo/tomographic parameters. Consideration of the several novel factors which have the potential to be biomarkers in addressing several unanswered questions in the disease process could help in the better predictive ability of progression or vision loss and customization of treatment options. This article delves into the understanding of these novel factors or biomarkers based on the pathogenesis of KC and features a special focus on their potential clinical applications and their future role in personalized medicine.
圆锥角膜（KC）是一种复杂的多因素角膜扩张性疾病，通常在二三十岁发病，严重影响视力的数量、质量和生活质量。在过去二十年中，人们研究了多种途径和因素，如揉眼、炎症、氧化、代谢、遗传和激素等。然而，KC的治疗仍然基于一些“一刀切”的方法，并且主要由地形图/断层扫描参数指导。考虑到一些有可能成为生物标志物的新因素，有助于解决疾病过程中几个未解决的问题，从而提高对病情进展或视力丧失的预测能力，并实现治疗方案的个性化定制。本文基于KC的发病机制深入探讨对这些新因素或生物标志物的理解，并特别关注它们的潜在临床应用以及在个性化医疗中的未来作用。
