Population study: Keratoconus prevalent in adolescents with
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Keratoconus is more likely in adolescents with overweight or obesity than in their normal and underweight counterparts, according to an Israeli population study published in the American Journal of Ophthalmology. Barak and colleagues conducted a nationwide, population-based, cross-sectional study of the 579,946 candidates for military service in Israel who had an ophthalmological exam. Candidates were aged 16 to 19.9 years. They divided candidates into BMI-based quartiles, which included underweight (8.3%), normal weight (73.9%), overweight (10.7%) and obese (7.1%). The main outcome measure was the odds ratio for the association between BMI and keratoconus.

The general prevalence of keratoconus was 164 cases per 100,000 candidates and increased over time in all quartiles. From 2006 to 2014, the overall prevalence of keratoconus increased by 177%. “The marked increase in prevalence over a relatively short period” was surprising, Barak said. “One can attribute the results to better detection, but in our study group the same tests were done over time and still there was a big increase in prevalence in all groups examined. We have no clear answer why such an increase is happening.” Another unexpected finding was the strong association between BMI and keratoconus, Barak said.

There was the greatest prevalence and odds for keratoconus among adolescents with obesity, followed by adolescents with overweight and adolescents with underweight compared with adolescents with normal weight (prevalence, 154 per 100,000). The analysis was adjusted for gender, age, height, country of origin, and socioeconomic status.

“We did speculate that higher BMI may be connected to keratoconus, but not such striking evidence,” Barak said. “Our findings of the strong independent association of obesity and keratoconus have never been reported and was certainly a surprise we did not anticipate.”

Source:https://www.ajo.com/article/S0002-9394(20)30655-3/fulltext, Healio