gms | German Medical Science

Purpose: This study examines keratoconus characteristics across different age groups in a tertiary eye center, comparing pediatric and adult populations. Using Pentacam HR technology, we analyzed comprehensive corneal parameters to identify age-related patterns in disease presentation and severity. Our findings provide insights that may inform clinical decision-making and treatment strategies for keratoconus management.

Methods: This cross-sectional retrospective study analyzed 240 eyes from 120 keratoconus patients at a tertiary eye center. Patients were stratified into four age groups: 0–12 years (n=40), 13–18 years (n=40), 19–25 years (n=40), and ≥26 years (n=40). Keratoconus diagnosis was established using Pentacam corneal topography, pachymetry, refractive error assessment, and slit-lamp biomicroscopy. Disease staging followed the Amsler-Krumeich classification. Comprehensive corneal parameters were recorded including anterior and posterior surface measurements (K1, K2, KM, astigmatism), corneal thickness, corneal volume, anterior chamber depth, and Belin-Ambrosio enhanced ectasia parameters. Patients with previous ocular surgery, contact lens use, extensive corneal scarring, acute hydrops, or collagen crosslinking treatment were excluded. Statistical analysis employed Kruskal-Wallis and chi-square tests to compare parameters across age groups.

Results: Gender distribution, disease stage, and vision were similar across age groups. However, significant age-related differences were observed in corneal topography parameters and progression indices. The 0–12 age group showed higher central corneal thickness compared to the 13–18 and 19–25 groups, while anterior and posterior curvature measures (K1, K2, and KM) differed significantly among the pediatric and adult groups. Additionally, progression indices including anterior chamber depth, minimum and maximum values, and ART and IT measurements revealed notable variations, with the younger patients generally exhibiting higher values relative to older groups.

Conclusion: Our findings reveal significant age-dependent variations in corneal topography parameters and progression indices among keratoconus patients. The pediatric cohort, particularly those aged 0–12 years, demonstrated significantly higher central corneal thickness values and more pronounced alterations in both anterior and posterior corneal curvature measurements compared to their adult counterparts. Notably, several key progression indices including anterior chamber depth, Ambrosio Relational Thickness (ART), and Index of Thickness (IT) were markedly elevated in younger patients. These observations suggest a potentially more aggressive disease trajectory in pediatric keratoconus, which may necessitate different clinical approaches. The present study underscores the critical importance of early detection through comprehensive screening protocols, age-appropriate prognostic counseling, and individualized treatment strategies tailored to the patient’s developmental stage to optimize long-term visual outcomes in keratoconus management.