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Validation of a questionnaire on repeated eye-rubbing and ocular microtrauma in patients with keratoconus.

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Risk factors for keratoconus progression and changes in corneal swept source OCT parameters.

N Dabé1, M Kyheng2, D Touboul1

  • 1Ophthalmology Department, Bordeaux Hospital, place Amelie-Raba-Leon, 33000 Bordeaux, France.

Journal Francais D'Ophtalmologie
|December 18, 2025
PubMed
Summary

Early detection of keratoconus (KC) progression is crucial for timely treatment. This study identified key risk factors and corneal parameters using swept source OCT topography to predict KC advancement.

Keywords:
CorneaCornéeCross-linkingCrosslinkingFacteurs de risqueKeratoconusKératocôneOCTRisk factor

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Area of Science:

  • Ophthalmology
  • Corneal Imaging
  • Biomedical Engineering

Background:

  • Early identification of keratoconus (KC) progression is vital to prevent vision loss.
  • Keratoconus progression is challenging to detect at early stages.
  • Advanced imaging techniques are needed to monitor KC changes.

Purpose of the Study:

  • To analyze risk factors associated with keratoconus progression.
  • To evaluate changes in CASIA-2 swept source OCT topography (SS-OCT) corneal parameters in progressive versus nonprogressive KC.
  • To identify potential biomarkers for early keratoconus detection.

Main Methods:

  • Retrospective, single-center study at Bordeaux University Hospital.
  • Included 134 patients with KC, divided into progressive (n=59) and stable (n=75) groups.
  • Collected demographic, clinical, and SS-OCT topographic data.

Main Results:

  • Young age, asthma history, and severe KC were significant risk factors for progression.
  • CASIA Fourier high-order aberrations (CASIA HOA), Ectasia Screening Index (ESI), anterior maximal elevation, and posterior maximal elevation differed significantly between groups.
  • Keratometric Asymmetry Amplitude (KAA), SimKmax, Kapex ant, and CASIA spherical aberrations (CASIA AS) showed significant increases in the progressive group.

Conclusions:

  • A risk score combining clinical factors (age, asthma, eye rubbing) and topographic variables (CASIA HOA, ESI, elevations) may optimize KC patient follow-up.
  • KAA, Kapex, SimKmax, and CASIA AS are promising CASIA parameters for monitoring KC progression.
  • These parameters can serve as early warning signs for keratoconus advancement.