Tomographic and aberrometric assessment of first-time diagnosed paediatric keratoconus based on age ranges: a multicentre study.

Abstract

Purpose To describe pediatric keratoconus (KC) patients by tomographic and aberrometric characteristics at first diagnosis, in a multicenter study. Methods We included 278 eyes from 139 pediatric patients, with a first tomographic diagnosis (Pentacam®) of KC prior to 18years-old. KC classification was based on the KC Index (≥ 1.07) and Topographic Keratoconus Classification (TKC ≥ 1). Patients were divided based on age ranges (14 and under and over 14 years) and gender. Statistical analysis was performed with SPSS statistics 25.0. ANOVA factor was carried out comparing to compare groups. Results 278 eyes were screened, and 230 eyes were diagnosed with pediatric KC. Mean age was 15.48 ± 2.33 (6 to 18) years old. We found differences in terms of TKC (2.08 ± 0.89 and 2.38 ± 0.82, p < 0.05) and spherical aberration (-0.71 ± (r=0.69, p < 0.01). Conclusion 0.97 and -1.07 ± 1.36, p < 0.05) among the under 14 years old or under and above 14 years old groups, respectively. Overall, female pediatric KC patients presentedreported a more severe TKC, Belin Ambrosio Display, maximum keratometry, asphericity and primary and secondary coma aberrations compared to male KC patients. We observed a correlation between CDVA and asphericity (r= 0.71, p < 0.01), as well as between CDVA and spherical aberration Our findings revealed that the debut of KC is usually in a moderated to- advanced stage in the pediatric population at first diagnosis, particularly in female patients. Corneal tomography should be systematically performed in children with recent onset of corneal astigmatism.