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Keratoconus detection by novel indices in patients with Down syndrome: a cohort population-based study

  • Clinical Investigation
  • Published:
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Abstract

Purpose

To use novel indices to determine the prevalence of KC and its progression in patients aged 10–30 years with Down syndrome.

Study design

Cohort population-based study.

Methods

Two hundred twenty-six of 250 invited Down syndrome patients were enrolled. The diagnostic criteria were confirmed by two independent expert examiners using slit-lamp examinations and topographic indices measured by Pentacam HR (Oculus Optikgeräte): maximum keratometry centered on the steepest point (zonal Kmax-3 mm), Ambrósio's relational thickness (ART), inferior-superior asymmetry (IS-value), Belin/Ambrósio deviation value (BAD-D), the Tomographic and Biomechanical Index (TBI), and a posterior elevation map. In the KC cases, Corvis ST (Oculus Optikgeräte) was done. All the KC cases completed the second phase in 2017.

Results

KC was identified in 28 patients (12.39%; 95% confidence interval: 8.2–17.9%): 20 bilateral and eight unilateral cases. Of these, 24 were in the ≤ 20-years age group, and four, in the > 20-years age group. The frequency of KC was not significantly correlated with age (P = 0.804) or gender (P = 0.322). In the KC cases, the mean zonal Kmax-3 mm, ART-max, IS-value, BAD-D, CBI, and TBI were 50.40 ± 5.88 D, 321.63 ± 111.94 μm, 1.99 ± 2.51, 3.73 ± 3.12, 0.54 ± 0.61, and 0.86 ± 0.20, respectively, and the minimum corneal thickness was 492.17 ± 42.67 μm. Of the 28 patients, 39.6% showed progression, and all were in the ≤ 20-years age group.

Conclusion

The prevalence of KC in Down syndrome patients is significantly higher than that reported in non-Down syndrome individuals of the same age groups. The progression rate is approximately similar to that of the non-Down syndrome population. Screening programs should be applied to prohibit serious visual impairment in these populations.

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Acknowledgements

We thank Shiva Fayyaz who extracted the data and Dr Shiva Mehravaran who assisted us in the preparation of the manuscript.

Author information

Authors and Affiliations

  1. Noor Ophthalmology Research Center, Noor Eye Hospital, No. 96 Esfandiar Blvd, Vali’asr Ave, Tehran, Iran

    Hassan Hashemi, Kazem Amanzadeh, Mohammad Amin Seyedian, Ali Makateb & Soheila Asgari

  2. Noor Research Center for Ophthalmic Epidemiology, Noor Eye Hospital, Tehran, Iran

    Mohammad Miraftab

  3. St Paul’s Eye Unit, Royal Liverpool and Broadgreen University Hospital, Liverpool, UK

    Riccardo Vinciguerra

  4. Rio de Janeiro Corneal Tomography and Biomechanics Study Group, Rio de Janeiro, RJ, Brazil

    Renato Ambrósio Jr

  5. Federal University of the State of Rio de Janeiro (UNIRIO), Rio de Janeiro, RJ, Brazil

    Renato Ambrósio Jr

  6. Department of Ophthalmology and Visual Science, Department of Biomedical Engineering, The Ohio State University, Columbus, OH, USA

    Cynthia Roberts

  7. Department of Biomedical Sciences, Humanitas University, Pieve Emanuele Milan, Italy

    Paolo Vinciguerra

  8. Humanitas Clinical and Research, Rozzano, Italy

    Paolo Vinciguerra

Authors
  1. Hassan Hashemi
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  2. Mohammad Miraftab
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  3. Kazem Amanzadeh
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  4. Mohammad Amin Seyedian
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  6. Renato Ambrósio Jr
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  7. Cynthia Roberts
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  8. Ali Makateb
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  10. Soheila Asgari
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Corresponding author

Correspondence to Soheila Asgari.

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Conflicts of interest

H. Hashemi, None; M. Miraftab, None, K. Amanzadeh, None; M. A. Seyedian, None; R. Vinciguerra, Consultant fee (Oculus); R. Ambrósio Jr, Consultant fee (Oculus); C. Roberts, Consultant fee (Oculus, Ziemer); A. Makateb, None; P. Vinciguerra, Consultant fee (Oculus, Schwind); S. Asgari, None.

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Corresponding Author: Soheila Asgari

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Hashemi, H., Miraftab, M., Amanzadeh, K. et al. Keratoconus detection by novel indices in patients with Down syndrome: a cohort population-based study. Jpn J Ophthalmol 64, 285–291 (2020). https://doi.org/10.1007/s10384-020-00725-4

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  • DOI: https://doi.org/10.1007/s10384-020-00725-4

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