Rashid Zahra Aly, Mashige Khathutshelo Percy, Moodley Vanessa Raquel
Discipline of Optometry, School of Health Sciences, University of KwaZulu-Natal, Durban, South Africa.
Int Ophthalmol. 2025 Jan 9;45(1):21. doi: 10.1007/s10792-024-03370-9.
To determine the prevalence and demographic profile of keratoconus (KC) among high school students in Nairobi County, Kenya.
In this population-based, prospective, cross-sectional study, multistage cluster sampling was used to select the participants. All students underwent visual acuity measurement, auto-refraction, retinoscopy and corneal topography. Students with a scissors reflex on retinoscopy or corneal topography patterns suspicious of KC were referred for corneal tomography.
A total of 3051 students from 29 schools, with a mean age of 17.4 ± 1.6 years (range: 13-25 years) were screened. The prevalence of KC was 1.7% (n = 51) (95% CI, 1.2-2.2) and of KC suspects was 3.8% (n = 117) (95% CI, 3.2-4.6). There were no significant associations between the prevalence of KC and gender, age or ethnicity (all p > 0.05). In the KC group, 88.2% (n = 45) were unaware of their condition, 52.9% (n = 27) were treated for allergic conjunctivitis, 45.1% (n = 23) required spectacles, 11.8% (n = 6) were recommended contact lenses in at least one eye and 49.0% (n = 25) were recommended corneal cross-linking.
Among adolescents, the results of this study indicate a higher prevalence of KC compared to that reported in South Korea, Norway, Brazil and Caucasians in New Zealand, but less than that reported in some countries in the Middle East. Given the high prevalence revealed in this study, a national school screening program and clinical guidelines for screening, diagnosis and management of KC is recommended.
确定肯尼亚内罗毕县高中生圆锥角膜（KC）的患病率及人口统计学特征。
在这项基于人群的前瞻性横断面研究中，采用多阶段整群抽样来选择参与者。所有学生均接受视力测量、自动验光、检影验光和角膜地形图检查。检影验光出现剪刀反射或角膜地形图模式可疑为KC的学生被转诊进行角膜断层扫描。
共筛查了来自29所学校的3051名学生，平均年龄为17.4±1.6岁（范围：13 - 25岁）。KC的患病率为1.7%（n = 51）（95%CI，1.2 - 2.2），KC疑似病例的患病率为3.8%（n = 117）（95%CI，3.2 - 4.6）。KC的患病率与性别、年龄或种族之间均无显著关联（所有p>0.05）。在KC组中，88.2%（n = 45） unaware of their condition（此处原文有误，推测为were unaware of their condition）不知道自己的病情，52.9%（n = 27）曾因过敏性结膜炎接受治疗，45.1%（n = 23）需要佩戴眼镜，11.8%（n = 6）至少有一只眼睛被建议佩戴隐形眼镜，49.0%（n = 25）被建议进行角膜交联。
在青少年中，本研究结果表明，与韩国、挪威、巴西以及新西兰的高加索人报道的患病率相比，KC的患病率更高，但低于中东一些国家报道的患病率。鉴于本研究揭示的高患病率，建议开展全国性的学校筛查项目以及KC筛查、诊断和管理的临床指南。
