Corrêa Dhiogo Cezar, Dantas Daniel Oliveira, Amaral Dillan Cunha, Moreira Hamilton, Louzada Ricardo Noguera, Alves Milton Ruiz
Division of Ophthalmology, Faculty of Medicine, University of São Paulo, São Paulo, São Paulo, Brazil.
Department of Computer Science, Federal University of Sergipe, São Cristovão, Sergipe, Brazil.
Optom Vis Sci. 2025 Jun 1;102(6):400-405. doi: 10.1097/OPX.0000000000002261. Epub 2025 Jun 16.
Identifying potential modifiable risk factors for keratoconus progression is crucial for better outcomes. This study suggests that sleeping position may contribute to interocular asymmetry in keratoconus, providing an actionable target for patient education and clinical management and underscoring the importance of sleep posture in slowing disease progression.
This study aimed to investigate whether the preferred sleeping position can contribute to interocular asymmetry of keratoconus.
A clinical cross-sectional study was conducted on 50 patients (100 eyes) with grade I and II keratoconus (Amsler-Krumeich) and 40 individuals (80 eyes) without keratoconus. Corneal tomographic parameters from the Galilei G6 (keratometry plus curve [Steep K], mean keratometry [Sim K], thinner corneal thickness, central corneal thickness, Cone Location and Magnitude Index, dioptric asymmetry between the inferior and superior corneal hemispheres, and vertical coma) were obtained to assess interocular asymmetry. All participants answered a questionnaire about their preferred sleeping position. The eye positioned lower during sleep has been referred to as the dependent eye, and the eye positioned higher was classified as the nondependent eye, regardless of the sleeping position (lateral or ventral).
There were no significant differences between dependent and nondependent eyes regarding the evaluated tomographic variables among individuals without keratoconus. However, in individuals with keratoconus, statistically significant differences were observed between dependent and nondependent eyes for the following parameters: Steep K (47.89 vs. 45.78 D, p=0.0047), Sim K (46.54 vs. 44.42 D, p=0.0016); thinnest corneal thickness (445.84 vs. 460.34 μm, p=0.0057), central corneal thickness (463.03 vs. 477.6 μm, p=0.0125), vertical coma (-1.98 vs. -1.41 μm, p=0.0448), and total coma (1.60 vs. 1.22 μm, p=0.0495).
This study suggests that in individuals with keratoconus, the preferred sleeping position may contribute to keratoconus asymmetry in the dependent eye, regardless of whether the sleeping position is lateral or ventral.
识别圆锥角膜进展的潜在可改变风险因素对于获得更好的治疗效果至关重要。本研究表明，睡眠姿势可能导致圆锥角膜的双眼不对称，为患者教育和临床管理提供了一个可采取行动的目标，并强调了睡眠姿势在减缓疾病进展中的重要性。
本研究旨在调查偏好的睡眠姿势是否会导致圆锥角膜的双眼不对称。
对50例（100只眼）I级和II级圆锥角膜（Amsler-Krumeich分级）患者及40例（80只眼）非圆锥角膜个体进行了一项临床横断面研究。获取了来自Galilei G6的角膜断层扫描参数（角膜曲率计加曲线[陡峭K值]、平均角膜曲率[Sim K值]、角膜最薄厚度、中央角膜厚度、圆锥位置和大小指数、角膜上下半球之间的屈光不对称以及垂直彗差）以评估双眼不对称情况。所有参与者回答了一份关于其偏好睡眠姿势的问卷。无论睡眠姿势是侧卧还是俯卧，睡眠时位置较低的眼睛被称为受影响眼，位置较高的眼睛被归类为非受影响眼。
在非圆锥角膜个体中，受影响眼和非受影响眼在评估的断层扫描变量方面没有显著差异。然而，在圆锥角膜个体中，受影响眼和非受影响眼在以下参数方面存在统计学显著差异：陡峭K值（47.89对45.78 D，p = 0.0047）、Sim K值（46.54对44.42 D，p = 0.0016）；角膜最薄厚度（445.84对460.34μm, p = 0.0057）、中央角膜厚度（463.03对477.6μm, p = 0.0125）、垂直彗差（-1.98对-1.41μm, p = 0.0448）以及总彗差（1.60对1.22μm, p = 0.0495）。
本研究表明，对于圆锥角膜个体，无论睡眠姿势是侧卧还是俯卧，偏好的睡眠姿势可能会导致受影响眼的圆锥角膜不对称。
