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Bikbov MM, Kazakbaeva GM, Gilmanshin TR, Iakupova EM, Fakhretdinova AA, Tuliakova AM, Panda-Jonas S, Rusakova IA, Gilemzianova LI, Khakimov DA, Miniazeva LA, Usubov EL, Jonas JB. Prevalence and Associations of Keratoconus Among Children, Adults, and Elderly in the Population-Based Ural Eye Studies. Asia Pac J Ophthalmol (Phila) 2023; 12:591-603. [PMID: 38117599 DOI: 10.1097/apo.0000000000000639] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2023] [Accepted: 08/14/2023] [Indexed: 12/22/2023] Open
Abstract
PURPOSE To estimate prevalence and associations of keratoconus in populations in Russia with an age from childhood to seniority. METHODS The study population consisted of the cohorts of 3 population-based studies performed in urban and rural areas within the same geographical region in Bashkortostan/Russia: the Ural Children Eye Study (UCES; age = 6-18 y; n = 4890), the Ural Eye and Medical Study (UEMS; age = >40 y; n = 5314), and the Ural Very Old Study (UVOS; age = >85 y; n = 651). Based on Scheimflug imaging, keratoconus was defined by a keratometric reading of ≥48 diopters (D) in any eye. RESULTS The mean maximal and minimal corneal refractive power increased from the UCES (43.58 ± 1.50 D and 42.70 ± 1.42 D, respectively) to the UEMS (44.26 ± 1.70 D and 43.61 ± 1.76 D, respectively) and to the UVOS (45.1 ± 1.72 D and 43.98 ± 1.68 D, respectively). Correspondingly, keratoconus prevalence increased from the UCES (42/4890; 0.086%; 95% CI = 0.060, 0.112) to the UEMS (112/5314; 2.11%; 95% CI = 1.72, 2.49) and to the UVOS (42/651; 6.45%; 95% CI = 4.56, 8.34). In the UCES, higher keratoconus prevalence was associated (multivariable analysis) with higher birth order [odds ratio (OR) = 2.34; 95% CI = 1.32, 4.15; P = 0.004], lower birth weight (OR = 0.99; 95% CI = 0.99, 0.99; P < 0.001), and shorter axial length (OR = 0.15; 95% CI = 0.08, 0.30; P < 0.001). In the UEMS, keratoconus prevalence correlated with shorter axial length (OR = 0.15; 95% CI = 0.10, 0.23; P < 0.001), larger corneal volume (OR = 1.17; 95% CI = 1.09, 1.25; P = 0.001), thicker lens (OR = 2.27; 95% CI = 1.06, 5.28; P = 0.04), cortical cataract degree (OR = 1.02; 95% CI = 1.01, 1.04; P = 0.01), and higher stage of age-related macular degeneration (OR = 1.65; 95% CI = 1.09, 2.51; P = 0.02). In the UVOS, keratoconus prevalence correlated with lower educational level (OR = 0.84; 95% CI = 0.71, 0.99; P = 0.04) and lower dynamometric handgrip force (OR = 0.92; 95% CI = 0.88, 0.97; P = 0.003). CONCLUSIONS In this study on multiethnic groups from Russia, keratoconus prevalence increased from the pediatric group (0.09%) to the adult group (2.11%) and seniority group (6.45%), correlated mostly with biometric ocular parameters and was in all age groups statistically independent of most systemic parameters.
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Affiliation(s)
| | | | | | - Ellina M Iakupova
- Ufa Eye Research Institute, Ufa, Russia
- Ufa Eye Institute, Ufa, Russia
| | | | | | - Songhomitra Panda-Jonas
- Privatpraxis Prof Jonas und Dr Panda-Jonas, Heidelberg, Germany
- Department of Ophthalmology, Medical Faculty Mannheim, Heidelberg University, Mannheim, Germany
- Institute of Molecular and Clinical Ophthalmology Basel, Basel, Switzerland
| | | | | | | | - Liana A Miniazeva
- Ufa Eye Research Institute, Ufa, Russia
- Ufa Eye Institute, Ufa, Russia
| | | | - Jost B Jonas
- Privatpraxis Prof Jonas und Dr Panda-Jonas, Heidelberg, Germany
- Department of Ophthalmology, Medical Faculty Mannheim, Heidelberg University, Mannheim, Germany
- Institute of Molecular and Clinical Ophthalmology Basel, Basel, Switzerland
- Singapore Eye Research Institute, Singapore National Eye Centre, Singapore
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Skorodumova LO, Belodedova AV, Sharova EI, Zakharova ES, Iulmetova LN, Bikbov MM, Usubov EL, Antonova OP, Selezneva OV, Levchenko A, Fedorenko OY, Ivanova SA, Gainetdinov RR, Malyugin BE. Rare single nucleotide variants in COL5A1 promoter do not play a major role in keratoconus susceptibility associated with rs1536482. BMC Ophthalmol 2021; 21:357. [PMID: 34625056 PMCID: PMC8501560 DOI: 10.1186/s12886-021-02128-6] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/11/2021] [Accepted: 09/24/2021] [Indexed: 12/20/2022] Open
Abstract
BACKGROUND Keratoconus is a chronic degenerative disorder of the cornea characterized by thinning and cone-shaped protrusions. Although genetic factors play a key role in keratoconus development, the etiology is still under investigation. The occurrence of single-nucleotide polymorphisms (SNPs) associated with keratoconus in Russian patients is poorly studied. The purpose of this study was to validate whether three reported keratoconus-associated SNPs (rs1536482 near the COL5A1 gene, rs2721051 near the FOXO1 gene, rs1324183 near the MPDZ gene) are also actual for a Russian cohort of patients. Additionally, we investigated the COL5A1 promoter sequence for single-nucleotide variants (SNVs) in a subgroup of keratoconus patients with at least one rs1536482 minor allele (rs1536482+) to assess the role of these SNVs in keratoconus susceptibility associated with rs1536482. METHODS This case-control study included 150 keratoconus patients and two control groups (main and additional, 205 and 474 participants, respectively). We performed PCR targeting regions flanking SNVs and the COL5A1 promoter, followed by Sanger sequencing of amplicons. The additional control group was genotyped using an SNP array. RESULTS The minor allele frequency was significantly different between the keratoconus and control cohorts (main and combined) for rs1536482, rs2721051, and rs1324183 (p-value < 0.05). The rare variants rs1043208782 and rs569248712 were found in the COL5A1 promoter in two out of 94 rs1536482+ keratoconus patients. CONCLUSION rs1536482, rs2721051, and rs1324183 were associated with keratoconus in a Russian cohort. SNVs in the COL5A1 promoter do not play a major role in keratoconus susceptibility associated with rs1536482.
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Affiliation(s)
- Liubov O Skorodumova
- Laboratory of Human Molecular Genetics, Federal Research and Clinical Center of Physical-Chemical Medicine of Federal Medical Biological Agency, 1a Malaya Pirogovskaya Ul, Moscow, Russian Federation, 119435.
| | - Alexandra V Belodedova
- Laboratory of Human Molecular Genetics, Federal Research and Clinical Center of Physical-Chemical Medicine of Federal Medical Biological Agency, 1a Malaya Pirogovskaya Ul, Moscow, Russian Federation, 119435.,Department of Anterior Segment Transplant and Optical Reconstructive Surgery, S. Fyodorov Eye Microsurgery Complex Federal State Institution, 59a Beskudnikovskiy Blv, Moscow, Russian Federation, 127486
| | - Elena I Sharova
- Laboratory of Human Molecular Genetics, Federal Research and Clinical Center of Physical-Chemical Medicine of Federal Medical Biological Agency, 1a Malaya Pirogovskaya Ul, Moscow, Russian Federation, 119435
| | - Elena S Zakharova
- Laboratory of Human Molecular Genetics, Federal Research and Clinical Center of Physical-Chemical Medicine of Federal Medical Biological Agency, 1a Malaya Pirogovskaya Ul, Moscow, Russian Federation, 119435
| | - Liliia N Iulmetova
- Laboratory of Human Molecular Genetics, Federal Research and Clinical Center of Physical-Chemical Medicine of Federal Medical Biological Agency, 1a Malaya Pirogovskaya Ul, Moscow, Russian Federation, 119435
| | - Mukharram M Bikbov
- Department of Surgery of the Cornea and Lens, Ufa Eye Research Institute, Academy of Sciences of the Republic of Bashkortostan, 90 Pushkina Ul, Ufa, Russian Federation, 450008
| | - Emin L Usubov
- Department of Surgery of the Cornea and Lens, Ufa Eye Research Institute, Academy of Sciences of the Republic of Bashkortostan, 90 Pushkina Ul, Ufa, Russian Federation, 450008
| | - Olga P Antonova
- Department of Anterior Segment Transplant and Optical Reconstructive Surgery, S. Fyodorov Eye Microsurgery Complex Federal State Institution, 59a Beskudnikovskiy Blv, Moscow, Russian Federation, 127486
| | - Oksana V Selezneva
- Laboratory for Genomic Research and Computational Biology, Federal Research and Clinical Center of Physical-Chemical Medicine of Federal Medical Biological Agency, 1a Malaya Pirogovskaya Ul, Moscow, Russian Federation, 119435
| | - Anastasia Levchenko
- Theodosius Dobzhansky Center for Genome Bioinformatics, Saint Petersburg State University, 7/9 Universitetskaya Nab, Saint Petersburg, 199034, Russia
| | - Olga Yu Fedorenko
- Laboratory of Molecular Genetics and Biochemistry, Mental Health Research Institute, Tomsk National Research Medical Center, Russian Academy of Sciences, 4 Aleutskaya Ul, Tomsk, 634014, Russia.,Division for Testing and Diagnostics, National Research Tomsk Polytechnic University, 30 Lenina Prosp, Tomsk, 634050, Russia
| | - Svetlana A Ivanova
- Laboratory of Molecular Genetics and Biochemistry, Mental Health Research Institute, Tomsk National Research Medical Center, Russian Academy of Sciences, 4 Aleutskaya Ul, Tomsk, 634014, Russia.,Division for Testing and Diagnostics, National Research Tomsk Polytechnic University, 30 Lenina Prosp, Tomsk, 634050, Russia.,Addiction Psychiatry and Psychotherapy Department, Siberian State Medical University, 2 Moskovsky Trakt, Tomsk, 634055, Russia
| | - Raul R Gainetdinov
- Laboratory of Neuroscience and Molecular Pharmacology, Institute of Translational Biomedicine and Saint Petersburg State University Hospital, Saint Petersburg State University, 7/9 Universitetskaya Nab, Saint Petersburg, 199034, Russia
| | - Boris E Malyugin
- Department of Anterior Segment Transplant and Optical Reconstructive Surgery, S. Fyodorov Eye Microsurgery Complex Federal State Institution, 59a Beskudnikovskiy Blv, Moscow, Russian Federation, 127486
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Abstract
This review was conducted due to the growing number of patients with keratoconus requiring cataract surgery and the complexity of surgical planning. The article reviews preoperative planning, intraoperative options, and postoperative management, which can help obtain high functional results. Treatment of cataracts in keratoconic eyes requires a multifaceted approach. In some cases, in the preoperative period, interventions such as crosslinking and implantation of intrastromal segments or corneal ring may be required to ensure stable keratometry values for accurate intraocular lens (IOL) calculations. The use of stabilizing procedures prior to optical biometrics can assist in preoperative lens selection and provide predictable surgical outcomes. To achieve targeted refraction and reduce unwanted optical effects, it is necessary to take a critical approach when choosing the type of lens (toric, monofocal). This is due to the appearance of aberrations of different order after preliminary surgical interventions on the cornea. The intraoperative decision plays important role in choosing the position of the corneal incisions, how to use sutures for wound adaptation, choosing scleral approaches to minimize possible postoperative complications. In the postoperative period, the degree of irregular astigmatism and the need for rigid gas-permeable or scleral lenses should be assessed.
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Abstract
AIM to evaluate the clinical effectiveness of crosslinking in patients with progressive pellucid marginal corneal degeneration (PMCD). MATERIAL AND METHODS A total of 9 patients (16 eyes) with progressive PMCD were treated by standard crosslinking. The cornea was saturated with Dextralink solution and UV-A irradiated at 3 mW/cm2 for 30 minutes. The follow-up period was 12 months. RESULTS One month after treatment, there was a slight decrease in uncorrected and best corrected visual acuity (UCVA and BCVA) - from 0.08±0.03 and 0.4±0.15 preoperatively down to 0.06±0.02 and 0.3±0.07, respectively, caused by pseudohaze of the cornea. Keratometric parameters (the average refractive power of the cornea, corneal astigmatism, and corneal thickness) did not change significantly. The demarcation line was identified in 56% of cases. By the 3-month follow-up, UCVA and BCVA improved up to 0.1±0.07 and 0.52±0.1, respectively. The refractive power of the cornea decreased by 2.0 diopters and corneal astigmatism - by 0.7 diopters reaching 46.8±2.7 and 5.1±1.3 diopters, respectively (p≤0.04). Central corneal thickness decreased by an average of 29 microns. The demarcation line remained visible in 25% of cases. At 6 months, BCVA averaged 0.58±0.13, at that, 56% of eyes gained 1 line and 31% - 2 lines. The refractive power of the cornea decreased down to 45.7±1.6 diopters, corneal astigmatism - down to 4.8±1.5 diopters. The demarcation line was not detected. At 1 year, there were no significant changes in the average values of optometric indices as compared to the 6-month period. Сonclusion. Pellucid marginal corneal degeneration should be regarded as a kind of primary ectasia, often bilateral and notable for its characteristic clinical picture and late onset. In progressive disease, photochemical crosslinking of the cornea contributes to the improvement of optometric parameters and stabilization of the process.
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Affiliation(s)
- M M Bikbov
- Ufa Eye Research Institute, Academy of Sciences of the Republic of Bashkortostan, 90 Pushkin St., Ufa, Russia, 450008
| | - V K Surkova
- Ufa Eye Research Institute, Academy of Sciences of the Republic of Bashkortostan, 90 Pushkin St., Ufa, Russia, 450008
| | - A R Khalimov
- Ufa Eye Research Institute, Academy of Sciences of the Republic of Bashkortostan, 90 Pushkin St., Ufa, Russia, 450008
| | - E L Usubov
- Ufa Eye Research Institute, Academy of Sciences of the Republic of Bashkortostan, 90 Pushkin St., Ufa, Russia, 450008
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Abstract
This review presents basic information on UV corneal crosslinking. The method is widely used in ophthalmology to treat various types of ectasia, which are characterized by progressive degenerative changes in the cornea, associated with its thinning , hazing and scarring, which leads to a significant reduction in visual acuity. Crosslinking is based on ultraviolet (UV) irradiation of the cornea wavelength 370 nm in the presence of riboflavin, leading to photochemical intracorneal interactions. As a result of crosslinking of collagen treatments, an increase of strength and mechanical properties of the cornea, stops the progression of the disease. The article displays the steps of the method development and the ways of its implementation are described especially occurring biomechanical, biochemical, morphological and ultrastructural changes, as well as the main areas of clinical application of riboflavin-UV-A-induced crosslinking of cornea.
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