Abstract
Purpose: To evaluate corneal elevation changes in patients with allergic conjunctivitis (AC) and to analyze their correlations with ocular allergy signs and corneal biomechanical alterations.Methods: Thirty patients (30 eyes) with AC and twenty normal subjects (20 eyes) were included in this prospective study. All participants underwent a complete ocular examination, including corneal tomography by Pentacam and corneal biomechanics evaluation by Corvis ST. AC patients were evaluated for their eye rubbing frequency and ocular allergic signs.Results: The elevation at the thinnest location (TE) and the central location (CE), the elevation difference at the thinnest location (TED) and the central location (CED), and the mean value of elevation difference in the central 4 mm zoom (MED) of both the anterior and posterior corneal surface were significantly higher in the AC group than in the normal group (p < 0.05 for all). In AC patients, only anterior corneal elevation parameters were positively correlated with eye rubbing frequency and ocular allergy sign severity (p < 0.05 for all), while the tomography and biomechanical index (TBI) was positively correlated with the elevation parameters of both the anterior and posterior corneal surfaces (p < 0.05 for all).Conclusion: AC patients carry an increased risk of corneal ectasia. Posterior corneal elevation parameters are sensitive and reliable predictors of keratoconus (KC) risk in AC patients.Clinical Trial Registration: https://clinicaltrials.gov/ct2/show/NCT04299399, identifier [NCT04299399].
Highlights
Allergic conjunctivitis (AC) is a common ocular surface disease that affects more than 20% of the population [1]
The elevation at the thinnest location (TE) and the central location (CE), the elevation difference at the thinnest location (TED) and the central location (CED), and the mean value of elevation difference in the central 4 mm zoom (MED) of both the anterior and posterior corneal surface were significantly higher in the AC group than in the normal group (p < 0.05 for all)
In AC patients, only anterior corneal elevation parameters were positively correlated with eye rubbing frequency and ocular allergy sign severity (p < 0.05 for all), while the tomography and biomechanical index (TBI) was positively correlated with the elevation parameters of both the anterior and posterior corneal surfaces (p < 0.05 for all)
Summary
Allergic conjunctivitis (AC) is a common ocular surface disease that affects more than 20% of the population [1]. AC has been found to be positively associated with early unset of KC This association may still be underestimated in clinical analysis, since a considerable number of AC patients have subclinical presentation of KC [7]. This subclinical population needs close monitoring for KC development. Taking into consideration that compared to the anterior corneal surface, the posterior cornea surface is less affected by corneal epithelial conditions and tear film stability, previous studies proposed posterior corneal elevations as more sensitive and reliable shape parameters for differentiating subclinical KC [15, 16]
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