Progressive corneal ectatic disease in pregnancy.

Area of Science:

• Ophthalmology
• Corneal Ectasia Research
• Pregnancy-Related Ocular Changes

Background:

• Pregnancy can induce significant ocular changes.
• These changes may trigger new or exacerbate existing corneal pathologies like keratoconus or keratectasia.

Purpose of the Study:

• To review existing evidence on the association between pregnancy and progressive keratoconus or iatrogenic keratectasia.
• To assess ophthalmic outcomes in women experiencing these conditions during or shortly after pregnancy.

Main Methods:

• Systematic search of ten online databases for eligible English-language studies.
• Inclusion of studies reporting objective ophthalmic outcomes for women with new-onset, progressive, or iatrogenic ectasia.
• Assessment of evidence strength using the Oxford Centre for Evidence-Based Medicine levels.

Main Results:

• Seventeen articles reported on 33 women with peripartum ectasia.
• Observed outcomes included corneal hydrops/protrusion, steepening on topography, decreased visual acuity, increased keratometry, and altered refractive error (spherical equivalent and astigmatism).
• Pregnancy-associated ectasia occurred in women with pre-existing keratoconus, post-refractive surgery history, and even in those with no prior corneal issues.

Conclusions:

• Pregnancy is linked to progressive corneal ectasia in susceptible women.
• Limited evidence highlights heterogeneity and the need for standardized definitions and prospective studies.
• Close monitoring and early intervention with collagen cross-linking are recommended for at-risk individuals to prevent vision loss.