Intereye asymmetry as a predictor of progression in patients with untreated keratoconus: findings from a longitudinal study

Purpose: The purpose of this study was to evaluate interocular predictors of progression in patients with untreated keratoconus. Methods: This is a multicenter longitudinal observational study with real-world data collected through the Save Sight Keratoconus Registry. Patients between the period of...

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Detalles Bibliográficos
Autores: Arnalich-Montiel, Francisco, Kandel, Himal, Lewis, Noni, Chiong Hong, Sheng, Downie, Nicholas, Watson, Adam, Abbondanza, Marco, Watson, Stephanie, Ortiz Toquero, Sara
Tipo de recurso: artículo
Estado:Versión aceptada para publicación
Fecha de publicación:2025
País:España
Institución:Universidad de Valladolid
Repositorio:UVaDOC. Repositorio Documental de la Universidad de Valladolid
OAI Identifier:oai:dnet:uvadoc______::739893b3eb339466db3926683146badf
Acceso en línea:https://doi.org/10.1097/ICO.0000000000003601
https://uvadoc.uva.es/handle/10324/79422
Access Level:acceso abierto
Palabra clave:Keratoconus
Progression
Intereye
Asymmetry
3201.09 Oftalmología
2209.15 Optometría
Descripción
Sumario:Purpose: The purpose of this study was to evaluate interocular predictors of progression in patients with untreated keratoconus. Methods: This is a multicenter longitudinal observational study with real-world data collected through the Save Sight Keratoconus Registry. Patients between the period of June 2000 and September 2022 were included in this study. Parameters such as patient age, sex, ocular history, visual acuity, K2, Max-K, and thinnest corneal thickness pachymetry (TCT) were analyzed. Results: There were 4342 untreated eyes from 2171 patients with keratoconus. A total of 333 patients showed progression of either Max-K, TCT, or both, whereas 1838 patients showed stable parameters. Factors associated with a higher incidence of progression in Max-K were younger baseline age (HR 0.96 per year older; 95% CI 0.95-0.98, P < 0.0001) and a higher baseline intereye asymmetry in Max-K (HR 1.02 per higher diopter; 95% CI 1.00-1.04, P = 0.04). A younger baseline age was the only predictor of progression in TCT (HR 0.97 per year older; 95% CI 0.95-0.99, P = 0.001). Conclusions: Age is the most significant predictor of progression for both corneal thinning and progression of Max-K. Interocular asymmetry in Max-K at baseline could be used as part of an algorithm for determining the risk of keratoconus progression. It is recommended that patients with higher interocular asymmetry in Max-K have a closer follow-up of both eyes as they are at a higher risk of progression.