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Effects of Atopic Syndrome on Keratoconus

Shajari, Mehdi MD; Eberhardt, Emanuel; Müller, Michael MD; Al Khateeb, Ghada MD; Friderich, Stefan; Remy, Matthias MD; Kohnen, Thomas MD, PhD, FEBO

doi: 10.1097/ICO.0000000000000935
Clinical Science

Purpose: To evaluate the effects of atopic syndrome on manifestations of keratoconus.

Methods: In this retrospective study, we reviewed patient files and data generated by Scheimpflug imaging of 670 eyes of 434 keratoconus patients. Patients were divided into a study group consisting of patients suffering from atopic syndrome (110 eyes of 75 patients), namely allergic asthma, atopic dermatitis, and/or allergic rhinitis, and a control group of patients without known atopic syndrome (560 eyes of 359 patients).

Results: We found a significant difference with the mean age being 36.1 ± 11.7 for the control group, 32.8 ± 9.6 for the atopic group (P = 0.002) with 1 atopic trait, and 30.4 ± 7.5 for patients with 2 or more atopic traits (P = 0.002). No statistically significant differences were found in the mean corrected distance visual acuity, corneal pachymetry, minimum relative pachymetric progression (RPI min), mean refraction, keratoconus index, anterior chamber depth and volume, K max, and location of K max in relation to the corneal apex. However, we found a significantly higher corneal density for the anterior 120 μm of the cornea in the atopic group (control: 20.74 ± 4.68, atopic group: 21.92 ± 4.65 P = 0.016).

Conclusions: Keratoconus patients suffering from atopic syndrome were significantly younger but showed no topographical changes except in corneal densitometry compared with keratoconus patients without an atopic disease. This suggests atopic syndrome is a factor, which can trigger earlier manifestation of keratoconus.

Department of Ophthalmology, Goethe-University, Frankfurt am Main, Germany.

Reprints: Thomas Kohnen, MD, PhD, FEBO, Department of Ophthalmology, Goethe-University, Theodor-Stern-Kai 7, 60590 Frankfurt am Main, Germany (e-mail:

M. Shajari, E. Eberhardt, M. Müller, G. A. Khateeb, and S. Friderich have no financial disclosures. M. Remy received travel support from Avedro and Schwind. T. Kohnen's is a consultant for Abbott, Alcon, Geuder, Rayner, Oculus, Schwind, TearLab, Thieme Compliance, Ziemer, and Zeiss.

Supported by Abbott, Alcon, Rayner, Oculus, Schwind, and Zeiss.

Received February 24, 2016

Received in revised form May 10, 2016

Accepted May 11, 2016

Copyright © 2016 Wolters Kluwer Health, Inc. All rights reserved.