Department of Ophthalmology, Hygeia Clinic, Gdańsk, Poland; Helsinki Retina Research Group, University of Helsinki, Finland.
Department of Ophthalmology, Hygeia Clinic, Gdańsk, Poland.
Cont Lens Anterior Eye. 2023 Aug;46(4):101846. doi: 10.1016/j.clae.2023.101846. Epub 2023 Apr 27.
Keratoconus is defined as central and/or paracentral corneal thinning and steepening with consequent irregular astigmatism. To date, no prospective study has reported its prevalence in Central Europe. This study aimed to evaluate the prevalence of keratoconus assessed with Scheimpflug imaging in a profile of general medicine practice in Poland.
This cross-sectional study collected data by inviting all patients aged 10-80 years subscribed to a single general practitioner in the Elbląg area, Poland. Corneal measurements were performed using a rotating Scheimpflug corneal tomography system. Three masked examiners established the diagnosis of keratoconus in the right or left eye. Fleiss' kappa coefficient (κ) was used to qualitatively analyze the interexaminer agreement.
Of 1,705 patients invited to the study, 771 agreed to participate (45.2%). The mean age of the 728 patients (60.6% female and 39.4% male) with gradable images in at least one eye was 53.6 ± 16.5 years. All of the examiners classified the same four cases as keratoconus (0.549%, 549 per 100,000, 95% confidence interval 150 to 1,400 per 100,000), of which two were bilateral. Fleiss' kappa showed almost perfect agreement among the three examiners regarding the diagnostic decision (κ = 0.784, 95% confidence interval 0.750 to 0.817, p < 0.001). The keratoconus cases were all women (p = 0.106), aged 48, 69, 70, and 71 years old.
The prevalence of keratoconus in this area was higher than that previously demonstrated in many European countries. Underestimation of the prevalence has been postulated but never demonstrated.
圆锥角膜的定义为中央和/或旁中央角膜变薄和变陡，导致不规则散光。迄今为止，尚无前瞻性研究报告其在中欧的流行率。本研究旨在评估在波兰的普通医学实践中使用 Scheimpflug 成像评估的圆锥角膜的患病率。
这项横断面研究通过邀请波兰埃尔布隆格地区的一名全科医生的所有 10-80 岁的患者参与，收集数据。使用旋转 Scheimpflug 角膜断层成像系统进行角膜测量。三名盲法检查者在右眼或左眼建立圆锥角膜的诊断。使用 Fleiss' kappa 系数（κ）对检查者间的一致性进行定性分析。
在受邀参加研究的 1705 名患者中，有 771 名同意参加（45.2%）。至少有一只眼睛可分级图像的 728 名患者（60.6%女性和 39.4%男性）的平均年龄为 53.6±16.5 岁。所有检查者都将同四个病例归类为圆锥角膜（0.549%，549/100,000，95%置信区间 150 至 1400/100,000），其中两个为双侧。Fleiss' kappa 显示三位检查者在诊断决策方面具有近乎完美的一致性（κ=0.784，95%置信区间 0.750 至 0.817，p<0.001）。这四个圆锥角膜病例均为女性（p=0.106），年龄分别为 48、69、70 和 71 岁。
该地区的圆锥角膜患病率高于许多欧洲国家以前的报告。患病率被低估，但从未得到证实。
