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Evaluating Natural Progression of Keratoconus in Relation to Age, Gender, and Disease Severity at Presentation.

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Τίτλος: Evaluating Natural Progression of Keratoconus in Relation to Age, Gender, and Disease Severity at Presentation.
Συγγραφείς: Ozalp O; Eskişehir Osmangazi University, Faculty of Medicine, Department of Ophthalmology, Eskişehir, Turkey., Ozaslan MK; Eskişehir Osmangazi University, Faculty of Medicine, Department of Ophthalmology, Eskişehir, Turkey., Apaydin F; Eskişehir Osmangazi University, Faculty of Medicine, Department of Ophthalmology, Eskişehir, Turkey., Karaatli M; Eskişehir Osmangazi University, Faculty of Medicine, Department of Ophthalmology, Eskişehir, Turkey.; Bitlis State Hospital, Ophthalmology Clinic, Bitlis, Turkey., Karaman BB; Eskişehir Osmangazi University, Faculty of Medicine, Eskişehir, Turkey., Yildirim N; Retired Professor of Eskişehir Osmangazi University, Faculty of Medicine, Department of Ophthalmology, Eskişehir, Turkey ; and., Dogan C; Istanbul University-Cerrahpaşa, Cerrahpaşa Faculty of Medicine, Department of Ophthalmology, Istanbul, Turkey ., Atalay E; Eskişehir Osmangazi University, Faculty of Medicine, Department of Ophthalmology, Eskişehir, Turkey.
Πηγή: Cornea [Cornea] 2026 Aug 01; Vol. 45 (8), pp. 1019-1025. Date of Electronic Publication: 2025 Sep 02.
Τύπος έκδοσης: Journal Article
Γλώσσα: English
Στοιχεία περιοδικού: Publisher: Lippincott Williams & Wilkins Country of Publication: United States NLM ID: 8216186 Publication Model: Print-Electronic Cited Medium: Internet ISSN: 1536-4798 (Electronic) Linking ISSN: 02773740 NLM ISO Abbreviation: Cornea Subsets: MEDLINE
Imprint Name(s): Publication: Hagerstown, MD : Lippincott Williams & Wilkins
Original Publication: New York, N.Y. : Masson Pub. USA, c1982-
Ιατρικοί όροι (MeSH): Keratoconus*/diagnosis , Keratoconus*/physiopathology , Keratoconus*/epidemiology , Cornea*/pathology, Corneal Topography/methods ; Humans ; Disease Progression ; Female ; Adult ; Male ; Adolescent ; Young Adult ; Severity of Illness Index ; Middle Aged ; Follow-Up Studies ; Sex Factors ; Retrospective Studies ; Age Factors ; Visual Acuity
Περίληψη: Purpose: To investigate the natural progression of keratoconus (KC) with respect to age, gender, and disease severity at presentation.
Methods: This study analyzed 949 eyes from 503 patients with KC followed at Eskişehir Osmangazi University and Istanbul University-Cerrahpaşa between 2009 and 2023. Patients with ≥1 year of follow-up with ≥3 Pentacam (Oculus, Inc) scans spaced ≥3 months apart were eligible. Progression was identified using Belin ABCD Progression Display using 2 baseline visits. Progression rates were analyzed according to age groups (≤18, >18 to ≤24, >24 to ≤30, >30 to <35, and ≥35 years), and KC severity was categorized based on the Topographic Keratoconus Classification (TKC) as subclinical, early-stage (TKC 1-2) and advanced-stage (TKC 3-4). Median time-to-progression (M-TTP) for progressive eyes was calculated with reference to the first presentation.
Results: Keratoconus progression rates declined significantly with age ( P < 0.001); however, 44.3% of patients aged ≥35 years still showed progression, with the highest rate in those ≤18 years (86.4%). In patients ≥35 years, advanced-stage disease (TKC 3 and 4) markedly increased progression risk (OR: 10.5 [ P = 0.03], 20.0 [ P = 0.008], respectively). The shortest time-to-progression occurred in patients aged ≤18 years (M-TTP: 8.6 and 5.8 months in TKC 1-2 and 3-4, respectively), whereas in those ≥35 years, advanced-stage disease progressed significantly earlier than early-stage (M-TTP: 18.9 vs. 38.2 months).
Conclusions: Although progression typically slows with age, 44% of patients ≥35 years still progressed. The shorter time-to-progression in younger individuals and in older patients with advanced disease at presentation highlight the need for close monitoring in both groups.
(Copyright © 2025 Wolters Kluwer Health, Inc. All rights reserved.)
Competing Interests: The authors have no funding or conflicts of interest to disclose.
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Contributed Indexing: Keywords: Belin ABCD progression display; age; keratoconus; keratoconus progression; topographic keratoconus classification
Entry Date(s): Date Created: 20250903 Date Completed: 20260701 Latest Revision: 20260702
Update Code: 20260702
DOI: 10.1097/ICO.0000000000003979
PMID: 40903038
Βάση Δεδομένων: MEDLINE
Περιγραφή
ISSN:1536-4798
DOI:10.1097/ICO.0000000000003979