Cornea Institute, LV Prasad Eye Institute, Telangana, India.
Centre for Eye Research Australia; Department of Surgery, Ophthalmology, The University of Melbourne, Melbourne, Australia.
Indian J Ophthalmol. 2022 Oct;70(10):3508-3513. doi: 10.4103/ijo.IJO_2579_21.
To study the demographics and clinical profile of keratoconus (KC) presenting in pre-teen children in India.
This was a retrospective case series conducted as a single-institutional study at a tertiary eye center in India. A total of 586 eyes from 294 KC patients (aged 12 years or less) without any active comorbid conditions of the eye were included in the study. Slit-lamp biomicroscopy was used to document the clinical signs of KC. Information on age; gender; reason for consultation; family history; history of allergy, atopy, and eye rubbing; manifest refraction; uncorrected and best-corrected distance visual acuity (UCVA and BCVA, respectively); clinical presentation; and contact lens usage were also analyzed, along with data on types of medical and surgical treatments for KC and their outcomes.
The mean age of this pediatric KC patient cohort was 9.3 ± 1.8 years, and there was a male (70%) preponderance. Baseline mean UCVA, BCVA, steep keratometry, and flat keratometry were 0.86 ± 0.58 logMAR, 0.44 ± 0.38 logMAR, 54.82 ± 8.4 D, and 48.21 ± 9.5 D, respectively. Progression, necessitating collagen crosslinking (CXL), was noted in 12.7% eyes. Post-CXL, visual and topographic parameters remained stable without any complications till 6 months posttreatment. However, in eyes that did not undergo CXL, significant progression over time (P < 0.001) was observed. A keratoplasty was required in 2.3% eyes.
KC was present at an advanced stage in 25% of the pre-teens in our series, and therefore, it is an important diagnostic entity when a refractive error is diagnosed, even in very young children.
研究印度未成年人群中圆锥角膜（KC）的人口统计学和临床特征。
这是一项在印度一家三级眼科中心进行的回顾性病例系列研究。共纳入 294 例 KC 患者（年龄在 12 岁及以下）的 586 只眼，这些患者均无眼部活动性合并症。使用裂隙灯生物显微镜记录 KC 的临床体征。分析的信息包括年龄、性别、就诊原因、家族史、过敏、特应性和揉眼史、眼前节检查、主觉验光、未矫正和最佳矫正远视力（UCVA 和 BCVA）、临床特征和角膜接触镜的使用情况，以及 KC 的药物和手术治疗类型及其结局的数据。
该儿科 KC 患者队列的平均年龄为 9.3 ± 1.8 岁，男性（70%）居多。基线时平均 UCVA、BCVA、陡峭角膜曲率和扁平角膜曲率分别为 0.86 ± 0.58 logMAR、0.44 ± 0.38 logMAR、54.82 ± 8.4 D 和 48.21 ± 9.5 D。12.7%的眼出现进展，需要行交联（CXL）治疗。CXL 术后 6 个月，视觉和地形图参数保持稳定，无任何并发症。然而，未行 CXL 的眼随时间出现显著进展（P < 0.001）。2.3%的眼需要行角膜移植。
在我们的系列研究中，25%的未成年患者的 KC 已处于晚期，因此，即使在非常年幼的儿童中，当诊断出屈光不正时，也应将其作为一个重要的诊断实体。
