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Prevalence of Keratoconus Based on Scheimpflug Corneal Tomography Metrics in a Pediatric Population From a
Jennifer S Harthan1, John D Gelles, Sandra S Block
1Illinois College of Optometry (J.S.H., S.S.B.), Chicago, IL; The Cornea and Laser Eye Institute-CLEI Center for Keratoconus (J.D.G, B.S., D.C., A.Y., S.A.G., P.S.H), Teaneck, NJ; Rutgers New Jersey Medical School (J.D.G., S.A.G., P.S.H.), Newark, NJ; Princeton Optometry (W.T.), Princeton, NJ; Walter Reed National Military Medical Center (A.S.M.), Walter Reed Eye Institute, Bethesda, MD; and North Suburban Vision Consultants and Keratoconus Specialists of Illinois (S.B.E.), Deerfield, IL.
Insights
The prevalence of keratoconus (KC) in children is higher than previously thought, with a rate of 1:334. Early detection through sensitive screening is crucial for pediatric eye exams.
Area of Science:
- Ophthalmology
- Corneal Diseases
- Pediatric Eye Care
Background:
- Keratoconus (KC) is a progressive thinning of the cornea.
- Accurate prevalence data in pediatric populations is limited.
- Early detection is key to managing KC progression.
Purpose of the Study:
- To determine the prevalence of keratoconus (KC) in children aged 3-18 years.
- To utilize Scheimpflug corneal tomography for diagnosis.
- To establish baseline prevalence data for pediatric KC.
Main Methods:
- Prospective observational study at Princeton Vision Clinic.
- Scheimpflug tomography (Pentacam HR) used for Belin/Ambrósio Enhanced Ectasia criteria (BAD3).
- Defined criteria for Non-KC, KC suspect, and KC based on Final D and Back Elevation at the Thinnest Point (BETP) measurements in 2007 subjects.
Main Results:
- Six subjects classified as KC, yielding a prevalence of 1:334.
- Three subjects identified as KC suspects, with a prevalence of 1:669.
- Overall prevalence of KC suspects and KC combined was 1:223.
Conclusions:
- Pediatric keratoconus prevalence is higher than previously reported.
- Highlights the need for sensitive KC screening in children.
- Recommends integrating early KC detection into standard pediatric eye examinations.
Purpose:
Determine the pediatric prevalence of keratoconus (KC) using Scheimpflug corneal tomography.
Methods:
A prospective observational study was done on subjects aged 3 to 18 years at the Princeton Vision Clinic, Chicago, IL. Scheimpflug tomography (Pentacam HR, OCULUS Optikgerate GmbH) scans (Belin/Ambrósio Enhanced Ectasia BAD3) yielded BAD Final D (Final D) and Back Elevation at the Thinnest Point (BETP) measurements. Criteria differentiating non-KC from KC suspects & KC were, Non-KC -Final D <2.00 in both eyes; KC suspect -Final D ≥2.00 and <3.00 in combination with BETP ≥18 μm for myopia and ≥28 μm for hyperopia/mixed astigmatism in at least one eye; and KC -Final D of ≥3.00 with BETP ≥18 μm for myopia or ≥28 μm for hyperopia/mixed astigmatism in at least one eye. Two thousand two hundred and six subjects were recorded, removing duplicate and poor-quality scans leaving 2007 subjects.
Results:
Of 2007 subjects, six were classified as KC -prevalence of 1:334, three subjects were KC suspects -prevalence of 1:669, and total prevalence of KC suspects and KC was 1:223.
Conclusion:
The prevalence of KC in children is higher than previously reported, emphasizing the importance of sensitive screening for KC at its earliest manifestation as standard in pediatric comprehensive eye examinations.
