Abstract
This retrospective, nationwide, matched-cohort study included 4488 new-onset keratoconus (KCN) patients, ≥12 years old, recruited between 2004 and 2011 from the Taiwan National Health Insurance Research Database. The control group included 26,928 non-KCN patients selected from the Taiwan Longitudinal Health Insurance Database 2000. Information for each patient was collected and tracked from the index date until December 2013. The incidence rate of mitral valve prolapse (MVP) was 1.77 times (95% confidence interval (CI) = 1.09–2.88; p = 0.0206) higher in KCN patients ≥40 years old and 1.49 times (95% CI = 1.12–1.98; p = 0.0060) higher in female KCN patients than in controls. After using the Cox proportional hazard regression analysis to adjust for potential confounders, including hypertension, hyperlipidemia, and congestive heart failure, KCN maintained an independent risk factor, MVP being 1.77 times (adjusted hazard ratio (HR) = 1.77, 95% CI = 1.09–2.88) and 1.48 times (adjusted HR = 1.48, 95% CI = 1.11–1.97) more likely to develop in patients ≥40 years old and female patients in the study cohort, respectively. We found that KCN patients ≥40 years of age and female KCN patients have increased risks of MVP. Therefore, it is recommended that KCN patients should be alerted to MVP.
Highlights
Keratoconus (KCN) is a bilateral, asymmetric, and progressive ectatic condition in which the affected cornea has a conical shape, leading to notable visual impairment [1]
Health Research Institute (NHRI) provides the National Health Insurance Research Database (NHIRD), which is the source of our data
The NHIRD records code information regarding the patient’s residential area, gender, and birthdate, as well as the International Classification of Diseases, Ninth Revision, Clinical Modification (ICD-9-CM) codes, including diagnoses and details of prescriptions, surgical or noninvasive procedures, and expenses, irrespective of where the patient is during hospitalization or under ambulatory care
Summary
Keratoconus (KCN) is a bilateral, asymmetric, and progressive ectatic condition in which the affected cornea has a conical shape, leading to notable visual impairment [1]. The disease has significant visual morbidity and is the main reason for keratoplasty in the developed world [2]. KCN affects all ethnicities and both genders. It typically appears in adolescence and advances until the third or fourth decade. The etiology of KCN is not fully understood. The cellular etiology of the disease is evaluated genetically, biochemically, and physically, and it has been implicated
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