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Natural history of keratoconus

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Last updated: July 18th, 2022

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Evidence

1. Natural history

Cohort study

2007 Wagner

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2007
Cohort study

At 8 years, there was a 2.03 and 4.06 letter decline in high- and low-contrast BCVA, 1.60D increase in the flat corneal meridian, and 20% incidence of corneal scarring. {Wagner H, Barr JT, Zadnik K. Collaborative Longitudinal Evaluation of Keratoconus (CLEK) Study: methods and findings to date. Cont Lens Anterior Eye. 2007 Sep;30(4):223-32.}

  • Cohort study of 1209 patients with keratoconus – the Collaborative Longitudinal Evaluation of Keratoconus (CLEK) Study
  • Findings (8-years):
    • BCVA decreased by 2.03 letters for high contrast and 4.06 letters for low contrast acuity
    • 10 or more letter decrease in 19% of subjects for high contrast and 31% of subjects for low contrast VA
    • Corneal curvature increased 1.60D in the flat corneal meridian, with 24% demonstrating increases of 3.00D or more.
    • Incidence of corneal scarring was 20%

Wagner
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2. Risk factors for progression

Review

2019 Ferdi et.al.

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2019
Review

Younger patients and those with Kmax steeper than 55 D at presentation have a significantly greater risk of progression of keratoconus.{Ferdi AC, Nguyen V, Gore DM, Allan BD, Rozema JJ, Watson SL. Keratoconus Natural Progression: A Systematic Review and Meta-analysis of 11 529 Eyes. Ophthalmology. 2019 Jul;126(7):935-945.}

Ferdi et.al.
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References

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