Corneal Topographic Changes in Children With Vernal Keratoconjunctivitis: Tertiary Hospital Report From Jammu and Kashmir, India

Abstract

BACKGROUND:Vernal keratoconjuctivitis has a known association with keratoconus. OBJECTIVE: Study was conducted to evaluate corneal topographic characteristics of patients with vernal keratoconjunctivitis (VKC) and compare the corneal topographic indices in VKC subjects with normal subjects. STUDY DESIGN: Prospective comparative study. MATERIAL AND METHODS: Videokeratography was done in 210 consecutive VKC patients and 201 age and sex matched normal subjects by Carl Zeiss meditec inc USA to evaluate corneal topography. Other tests included visual acuity testing with Snellens chart, slit lamp biomicroscopy, dilated fundus examination, measurement of central corneal thickness and intraocular pressure. Topographic indices were analyzed and compared using unpaired t-test among different groups. RESULT: Among 210 subjects with VKC, males comprised of 173 patients (82.3%) and mean age of presentation was 11.5±4.6 years with mixed VKC in 60%. Keratoconus-like topography was present in 64 patients (30.47%). CONCLUSION: Keratoconus-like topography was observed in very high proportion of patients of VKC.

The Topographic Corneal Changes in Patients with Vernal Keratoconjunctivitis

“…In two studies from India and Nepal, central corneal thickness was significantly reduced in VKC subjects with suspected keratoconus like topography. 9,13 Whereas in the study of Barreto and his friends, the pachymetry value of the corneal thinnest point of the patients diagnosed with VKC was found statistically significantly lower than the control group. 10 These changes in the corneal thickness can be explained by the fact that corneal epithelial trauma due to severe eye itching and keratocyte apoptosis lead to corneal thinning in the upcoming years.…”

“…Routine corneal topography in patients with VKC allows early detection and management of subclinical and clinical keratoconus. [7][8][9] Gautam and his friends conducted a study on VKC patients in Nepal. 28.7% of patients was diagnosed with palpebral, 14.8% of patients was diagnosed with limbal and 56.5% of patients was diagnosed with mixed VKC.…”

“…It has been showed that chronic epithelial defects result in changes in corneal topography by causing long term and slight oscillation in destructive enzymes. 3,[7][8][9] The studies conducted in previous years have shown the relation between keratoconus and VKC with clinical analysis. [9][10][11] Yet, with these methods, it cannot be proven the relationship between VKC and keratoconus in the patients with subclinical keratoconus.…”

“…3,[7][8][9] The studies conducted in previous years have shown the relation between keratoconus and VKC with clinical analysis. [9][10][11] Yet, with these methods, it cannot be proven the relationship between VKC and keratoconus in the patients with subclinical keratoconus. Quantitative analysis of anterior corneal surface by computerized corneal topography, topographic changes, subclinical and clinical keratoconus can be easily determined in the patients diagnosed with VKC.…”

Pentacam Corneal Imaging in Patients With Vernal Keratoconjunctivitis

“…In the study conducted by Nawaz et al (2012), they evaluated corneal topographic characteristics of patients with vernal keratoconjunctivitis (VKC) and compared the corneal topographic indices in VKC subjects with normal subjects. Central corneal thickness was found to be significantly decreased in VKC subjects compared to normal subjects.…”