ArticleThe British journal of ophthalmology2022
Nationwide epidemiological approach to identify associations between keratoconus and immune-mediated diseases.
Article in The British journal of ophthalmology, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 35 papers, 3 of them syntheses that pooled it.
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The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
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Who cites it
35 citing papers in PubMed, 3 syntheses or guidelines pooled it, 55 citations in OpenAlex.
- Association Between Keratoconus and Inflammatory Bowel Disease: A Systematic Review and Meta-Analysis.Cornea · 2026Pooled it
- Mendelian randomization and genetic analyses reveal causal roles of immune cells and inflammatory proteins in keratoconus.Scientific reports · 2025Pooled it
- The candidate proteins associated with keratoconus: A meta-analysis and bioinformatic analysis.PloS one · 2024Pooled it
- The Science and Clinical Evolution of Corneal Cross-Linking: Mechanism of Action, Ultra-Structural Changes, Clinical Indications, and Emerging Treatment Strategies.Ophthalmology and therapy · 2026Review
- NEDD8 Promotes the Progression and Inflammation of Keratoconus by Increasing the Expression of YAP1.Investigative ophthalmology & visual science · 2026Article
- Keratoconus: The Local Manifestation of a Systemic Disease?Journal of clinical medicine · 2025Review
- Bilateral Keratoconus in Diffuse Cutaneous Systemic Sclerosis: A Rare Presentation - Is There Any Role of Autoimmunity?Turkish journal of ophthalmology · 2025Article
- Pachychoroid pigment epitheliopathy in keratoconic eyes.Graefe's archive for clinical and experimental ophthalmology = Albrecht von Graefes Archiv fur klinische und experimentelle Ophthalmologie · 2025Observational
- Allergic disease and keratoconus: A two-sample univariable and multivariable Mendelian randomization study.The World Allergy Organization journal · 2024Article
- Machine learning methods to identify risk factors for corneal graft rejection in keratoconus.Scientific reports · 2024Article
- Keratoconus.Nature reviews. Disease primers · 2024Article
- Inflammatory and genomic interactions within keratoconus susceptible patients: a nationwide registered case-control study.Eye and vision (London, England) · 2024Article
- Causal Association Between Atopic Dermatitis and Keratoconus: A Mendelian Randomization Study.Translational vision science & technology · 2024Article
- Targeted next-generation sequencing analysis in Italian patients with keratoconus.Eye (London, England) · 2024Article
- Multi-dataset identification of innovative feature genes and molecular mechanisms in keratoconus.Journal of cellular and molecular medicine · 2024Article
- Ten-year incidence of keratoconus in relation to sex, age, and thyroid gland dysfunction: a nationwide population-based cohort study (2009-2018).Annals of translational medicine · 2024Article
- Mendelian Randomisation Analysis of Causal Association between Lifestyle, Health Factors, and Keratoconus.Bioengineering (Basel, Switzerland) · 2024Article
- Systemic and Ocular Associations of Keratoconus.Expert review of ophthalmology · 2024Article
- Thyroid gland dysfunction and keratoconus.Medical hypothesis, discovery & innovation ophthalmology journal · 2024Article
- Advanced bioengineering strategies broaden the therapeutic landscape for corneal failure.Frontiers in bioengineering and biotechnology · 2024Review
Corrections and comments
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Authors and funding
5 authors at 2 institutions in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundThe aetiology of keratoconus (KC) remains poorly understood. KC has typically been described as a non-inflammatory disorder of the cornea. Nonetheless, there is increasing presumptive evidence for the role of the immune system in the pathogenesis of KC.
aimTo evaluate the association between KC and immune-mediated diseases on a population level. We hypothesise that KC is immune-mediated rather than a predominantly degenerative disease.
methodsData were obtained from the largest health insurance provider in the Netherlands. Dutch residents are obligatorily insured. The data contained all medical claims and sociodemographic characteristics from all KC patients plus all those data from a 1:6 age-matched and sex-matched control group. The primary outcome was the association between KC and immune-mediated diseases, as assessed by conditional logistic regression.
resultsBased on our analysis of 2051 KC cases and 12 306 matched controls, we identified novel associations between KC and Hashimoto's thyroiditis (OR=2.89; 95% CI: 1.41 to 5.94) and inflammatory skin conditions (OR=2.20; 95% CI: 1.37 to 3.53). We confirmed known associations between KC and atopic conditions, including allergic rash (OR=3.00; 95% CI: 1.03 to 8.79), asthma and bronchial hyperresponsiveness (OR=2.51; 95% CI: 1.63 to 3.84), and allergic rhinitis (OR=2.20; 95% CI: 1.39 to 3.49).
conclusionKeratoconus appears positively associated with multiple immune-mediated diseases, which provides a population-based argument that systemic inflammatory responses may influence its onset. The identification of these particular diseases might shed light on potential comparable pathways through which this proinflammatory state is achieved, paving the way for pharmacological treatment strategies.
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Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.