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

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.