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Prevalence of Keratoconus Based on Scheimpflug Imaging: The Raine Study


Chan, E and Chong, EW and Lingham, G and Stevenson, LJ and Sanfilippo, PG and Hewitt, AW and Mackey, DA and Yazar, S, Prevalence of Keratoconus Based on Scheimpflug Imaging: The Raine Study, Ophthalmology, 128, (4) pp. 515-521. ISSN 0161-6420 (2021) [Refereed Article]

DOI: doi:10.1016/j.ophtha.2020.08.020


Purpose: To describe the prevalence and systemic associations of keratoconus in young adults in Perth, Western Australia.

Design: Cross-sectional study.

Participants: One thousand two hundred fifty-nine participants 20 years of age.

Methods: The Raine Study is a multigenerational, longitudinal cohort study based in Perth, Western Australia. This study represents a cross-sectional analysis of the birth cohort on returning for a 20-year follow-up. Participants underwent a detailed ophthalmic examination, including visual acuity assessment and Scheimpflug imaging using the Pentacam (Oculus, Wetzlar, Germany), and completed a health questionnaire. Keratoconus was defined as a Belin/Ambrόsio enhanced ectasia display score of 2.6 or more in either eye based on Pentacam imaging.

Main outcome measures: Prevalence of keratoconus in this cohort.

Results: Of the 1259 participants, 50.8% were women and 85.7% were White. Fifteen participants had keratoconus in at least 1 eye, giving a prevalence of 1.2% (95% confidence interval, 0.7%-1.9%), or 1 in 84. A significant difference was found in best-corrected visual acuity (0.01 logarithm of the minimum angle of resolution vs. -0.05 logarithm of the minimum angle of resolution; P = 0.007), cylinder (1.25 diopters [D] vs. 0.25 D cylinder; P < 0.001) and spherical equivalent (-1.42 D vs. -0.50 D sphere; P = 0.02) on objective refraction, mean keratometry of the steep meridian (45.19 D vs. 43.76 D; P < 0.001), and mean corneal thickness at the thinnest point (475 μm vs. 536 μm; P < 0.001) between those with and without keratoconus. Keratoconus was associated with regular cigarette smoking (38.5% vs. 14.6%; P = 0.04), but showed no association with gender, race, body mass index, use of spectacles or contact lenses, history of allergic eye disease, or pregnancy.

Conclusions: The prevalence of keratoconus in this Australian population-based study of 20-year-old adults was 1.2% (95% confidence interval, 0.7%-1.9%), or 1 in 84, which is one of the highest reported in the world. This has important implications for screening individuals at a younger age so that treatment can be initiated before disease progression.

Item Details

Item Type:Refereed Article
Keywords:corneal tomography, epidemiology, keratoconus
Research Division:Biomedical and Clinical Sciences
Research Group:Ophthalmology and optometry
Research Field:Ophthalmology
Objective Division:Health
Objective Group:Clinical health
Objective Field:Diagnosis of human diseases and conditions
UTAS Author:Hewitt, AW (Professor Alex Hewitt)
UTAS Author:Mackey, DA (Professor David Mackey)
ID Code:146229
Year Published:2021
Web of Science® Times Cited:32
Deposited By:Menzies Institute for Medical Research
Deposited On:2021-08-25
Last Modified:2021-08-25

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