Characteristics of keratoconic patients at two main eye centres in Palestine: a cross-sectional study

Abstract

BackgroundKeratoconus (KC) is a multifactorial, degenerative ectatic condition of the cornea. It usually manifests during late adolescence or the early twenties. A painless disease, KC may end with severe visual loss. The prevalence of KC in middle-eastern countries is much higher than in other regions of the world. This may be due to genetic and environmental risk factors and consanguinity. The goal of this study is to explore the demographic profile of Palestinian keratoconic patients.MethodsA retrospective study was conducted in two ophthalmology centres (Tertiary Ophthalmic Centre of An-Najah National University Hospital and An-Noor Centre at the Specialized Arab Hospital). All medical charts of keratoconic patients attending both centres over the period from 2009 to 2016 were reviewed. These patients were diagnosed by ophthalmologists depending on history, examination and Pentacam. Severity was determined using the k median index from the Pentacam map. Data analysis was carried out using SPSS Version 22.ResultsThe medical files of 936 keratoconic eyes of 505 keratoconic patients were reviewed. Their mean age at the time of diagnosis was 23.3 ranging from 8 to 62 years. Approximately 70.1% of them presented after the age of 20 years, and younger age groups were more likely to develop a severe disease stage than older ones (P = 0.001, r = − 0.108). There was a nearly equal distribution of patients between the two sexes (49.5% male, 50.5% female). On initial evaluation, the best-corrected visual acuity (BCVA) was recorded as ≥6/12 in most affected eyes (71.5%). Regarding severity, 62% presented in a mild form, while 9.9% were at a severe stage. About 88.2% presented with bilateralism.ConclusionsMost of the patients in their twenties presented with a mild bilateral form of the disease. This result is compatible with published international reports. It is recommended that the results of this study be considered when establishing a screening program in Palestine. Subsequently, patients will be identified at an appropriate time where action can be taken before disease progression take place.

Comparison of Topographic and Biomicroscopic Features Among Symptomatic Keratoconic Eyes

“…Shanti et al reported equal preference in both sexes. 9 Shett et al reported 53% female predominance. 10 Bilaterality was evident.…”

“…8 Shanti et al reported a mean age of 23.3 years. 9 Shetti et al reported a mean age of 21.5 years. 10 KC occurs at puberty, progresses until third or fourth decade and remains stationary thereafter.…”

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“…Keratoconus is a degenerative disease which characterized thinning and steepening of central and paracentral cornea which affects no sex predispostion [1]. Almost all cases are bilaterally, one eye was more affected than the other [2]. The disease is manifests during late adolescence and tends to progress to mid-thirties [2].…”

“…Almost all cases are bilaterally, one eye was more affected than the other [2]. The disease is manifests during late adolescence and tends to progress to mid-thirties [2]. Sometimes it marked progresion during childhood and puberty that may lead to severe visual loss [3].…”

“…The prevalence of keratoconus in the middle-eastern countries is much higher than in the regions of the world. This may be genetical and environmental risk factors [2]. Hot and humid climate, sun exposure are increased compliant like red-eye, ithching, photophobia etc.…”