Imagine this: nearly half of all adults with keratoconus are still facing a high rate of progression. It's a shocking statistic, but a recent study has shed some light on this eye-opening issue.
Keratoconus, or KC for short, is a progressive disease that affects the cornea. It's characterized by thinning and a conical shape, and it often starts to show up during adolescence. But here's where it gets controversial: while it's typically associated with younger individuals, this study reveals that older adults are not immune to its progression.
The study, published in Cornea, assessed the natural progression of KC across different age groups and disease severities. It included over 900 eyes from patients who presented to two universities in Turkey over a 14-year period.
The findings? Well, they're quite eye-opening. Overall, more than half of the cases showed disease progression, and the rates declined significantly with age. However, a significant 44% of patients aged 35 and above still experienced progression. And this is the part most people miss: the risk of progression increased markedly in older patients with advanced-stage KC.
The time it took for the disease to progress was also notable. Younger patients, aged 18 and below, had the shortest time-to-progression, while older patients with advanced disease progressed significantly sooner than those with early-stage KC.
But it's not all about age. The study also found that the progression rate was similar between men and women, and bilateral progression was most common in the youngest age group.
Experts note that initial maximum keratometry steepness is a strong indicator of progression, and a meta-analysis supports this, showing that higher baseline maximum keratometry leads to increased steepening over time.
While this study provides valuable insights, it's not without its limitations. For instance, not all patients had bilateral corneal tomographic data, and the progression criteria used may overdiagnose KC progression compared to other metrics.
So, what's the take-home message? While KC progression tends to slow with age, a significant number of older adults are still at risk. This highlights the need for close monitoring, especially in younger individuals and older patients with advanced disease.
What are your thoughts on these findings? Do they align with your understanding of KC progression? Feel free to share your insights and experiences in the comments below!
