Autoimmune Thyroid Disease and Keratoconus: Is There an Association?

Alhawari, Hussam; Khader, Yousef; Al‐Omari, Amal; Abbasi, Hiba N.; El-Faouri, Muhannd S.; Bdour, Muawyah

doi:10.1155/2018/7907512

Cited by 12 publications

(9 citation statements)

References 38 publications

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“…However, Alhawari et al. 20 found no association between autoimmune thyroid disease and keratoconus. Our study was limited by the small sample, which may affect the power and subsequently the results of the study.…”

Section: Discussionmentioning

confidence: 98%

Association Between Keratoconus and Thyroid Gland Dysfunction: A Cross-Sectional Case–Control Study

Elmassry¹,

Doheim²,

Iqbal³

et al. 2020

J Refract Surg

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K eratoconus is a corneal ectatic disorder that starts at puberty and decreases the radius of curvature of the central cornea. 1 Kennedy et al. 2 reported that the incidence rate is 1 per 50,000 among the population. Moreover, the pathophysiological processes underlying keratoconus have not been fully explained and proposed mechanisms including oxidative dam-age, proteolytic degradation in the corneal stroma, epithelial mechanical injury, immunological factors, and genetic factors have been suggested. [1][2][3][4] reported an incidence of keratoconus in 3.5% to 8% of patients with Down syndrome. Furthermore, hormonal imbalances affect the corneal metabolism and may be associated with keratoconus. Likewise, thyroid gland ABSTRACT PURPOSE: To examine the clinical association between thyroid gland dysfunction and keratoconus. METHODS:This was a cross-sectional case-control study conducted between May 2018 and July 2019. After performing Pentacam (Oculus Optikgeräte GmbH, Wetzlar, Germany) examination, flat, steep, and maximum simulated keratometric readings were recorded for each patient. Serum concentrations of free triiodothyronine, free thyroxine, and thyroidstimulating hormone were measured. Further examinations by an endocrinologist were indicated for patients with positive laboratory results to confirm thyroid gland dysfunction. RESULTS:One hundred eighty-seven patients with bilateral keratoconus and 187 sex-and age-matched healthy controls without keratoconus were analyzed. Mean age was 26.4 ± 8.2 years for the patients with keratoconus and 27.1 ± 9.4 years for the control patients, with no significant difference. The results showed that thyroid gland dysfunction prevalence was 10 of 187 patients with keratoconus (5.3%) and 2 of 187 control patients (1.1%), and the difference was statistically significant (P = .036). For the patients with keratoconus and thyroid gland dysfunction, 8 were women and 2 were men. Additionally, 6 patients (2 men and 4 women) had hyperthyrosis and 4 women had hypothyrosis. For controls, the two patients had hypothyrosis. CONCLUSIONS:This study showed that there is a possible association between keratoconus and thyroid gland dysfunction, but more studies are needed to build upon these results.[J Refract Surg. 2020;36(4):253-257.] (AT). © 2020 El-Massry, Doheim, Iqbal, et al.; licensee SLACK Incorporated. This is an Open Access article distributed under the terms of the Creative Commons . This license allows users to copy and distribute, to remix, transform, and build upon the article non-commercially, provided the author is attributed and the new work is non-commercial.

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Section: Discussionmentioning

confidence: 98%

Association Between Keratoconus and Thyroid Gland Dysfunction: A Cross-Sectional Case–Control Study

Elmassry¹,

Doheim²,

Iqbal³

et al. 2020

J Refract Surg

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“…Some authors reported that hypothyroidism might be associated with corneal ectasia and could be one of the casual factors, but the recent studies on the association between thyroid gland dysfunction and KC reported conflicting results. 15–20,26,27…”

Section: Discussionmentioning

confidence: 99%

“…9,10 Only few reports focused on the possible role of the thyroid gland dysfunction in the pathogenesis of keratoconus and the actual knowledge about the association between keratoconus and thyroid diseases remains poor and controversial. 15–20…”

Section: Introductionmentioning

confidence: 99%

Is keratoconus associated to thyroid diseases? Assessment of the corneal parameters in patients with congenital hypothyroidism

Roszkowska

Alessandrello

Waśniewska

et al. 2021

European Journal of Ophthalmology

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Purpose: To investigate the association between keratoconus and congenital hypothyroidism (CH). Patients and methods: Patients were enrolled in this study and divided into two groups. The first group comprised 31 subjects (11M:20F) with the mean age of 15.2 ± 3.9 years. affected by CH, and the control group was composed by 19 healthy individuals (8M:11F) aged 14.3 ± 4.6 years. All patients underwent complete ophthalmologic examination with visual acuity assessment, refraction, slit lamp examination, and retinoscopy. Corneal parameters were measured using Scheimpflug camera (Pentacam® Oculus, Germany). The main outcome measures considered for evaluation were: average corneal curvature (K), central corneal thickness (CCT), anterior elevation and posterior elevation at the thinnest point, corneal volume (CV), anterior chamber depth (ACD), and anterior chamber volume (ACV). Additionally, data from Belin/Ambrosio Enhanced Ectasia Display (BAD) and the high order aberrations were evaluated. Kolmogorov-Smirnov test was used to verify the Gaussian distribution, the comparison between the controls and cases group was performed by Mann-Whitney nonparametric test. A p value less than 0.05 was considered to be statistically significant. The odds ratio was performed in order to quantify the relationship between the congenital hypothyroidism and abnormal values displayed on front BAD. Results: The significant difference in the refractive status between both groups was observed. As to examined corneal and anterior chamber parameters no statistical differences were detected. Conclusions: Congenital hypothyroidism diagnosed and treated since the early postnatal life doesn’t induce abnormalities of corneal parameters suggestive for keratoconus.

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“…Identifying the risk factors associated with the need for PKP is important in the management of patients with keratoconus. Several studies have reported these factors but a limited number of studies were conducted in an Asian country despite the higher prevalence of the disorder in these countries [ 8 , 28 , 29 ]. Up to our knowledge, this is the first study that evaluates the association between paternal consanguinity and the need for PKP.…”

Section: Discussionmentioning

confidence: 99%

Environmental Risk Factors Associated With the Need for Penetrating Keratoplasty in Patients With Keratoconus

Elubous¹,

Bdour²,

Alshammari³

et al. 2021

Cureus

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To identify environmental risk factors associated with the need for penetrating keratoplasty (PKP) (fullthickness corneal transplantation) in patients with keratoconus in a Middle Eastern country. MethodsThis is a retrospective case-control study. This study included patients with keratoconus who underwent PKPor were waitlisted for PKP. Controls were patients diagnosed with keratoconus who did not reach a stage that necessitates PKP. Groups were matched by age and gender. Chi-square test was used to figure out the association between different risk factors including eye rubbing, vernal keratoconjunctivitis (VKC), smoking, paternal consanguinity, eye dryness, family history, asthma, eczema, and diabetes with the need for PKP. ResultsA total of 111 patients were included in this study, there were 48 (43.26%) men and 63 (56.75%) women. The case group included 42 subjects and the control group included 69 subjects. We found statistically significant differences between the two groups in relation to eye rubbing (p=0.0005), VKC (p=0.005), paternal consanguinity (p=0.02), and smoking rate (p=0.04), all being significant in the group in need of PKP. On the other hand, we did not find out a statistically significant difference between the two groups in relation to family history (p=0.31), dryness (p=0.58), asthma (p=0.15), eczema (p=0.28), or diabetes (p=0.29). ConclusionThis study has identified several risk factors associated with the need for PKP in patients with keratoconus, part of which are modifiable. These findings can benefit clinicians in community counseling and give recommendations that can help in preventing or -at least -delaying the need for PKP surgery in keratoconus, such as smoking cessation, aggressive treatment of VKC disease, eye rubbing avoidance, as well as raising awareness regarding the potential risks of paternal consanguinity in this disease entity.

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Autoimmune Thyroid Disease and Keratoconus: Is There an Association?

Cited by 12 publications

References 38 publications

Association Between Keratoconus and Thyroid Gland Dysfunction: A Cross-Sectional Case–Control Study

Association Between Keratoconus and Thyroid Gland Dysfunction: A Cross-Sectional Case–Control Study

Is keratoconus associated to thyroid diseases? Assessment of the corneal parameters in patients with congenital hypothyroidism

Environmental Risk Factors Associated With the Need for Penetrating Keratoplasty in Patients With Keratoconus

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