ArticleEye (London, England)2025
Keratoconus prevalence in astigmatic adolescents: findings from a nationwide screening setting.
Article in Eye (London, England), 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.
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Who cites it
1 citing paper in PubMed.
- Proportion and clinical characteristics of keratoconus among patients attending refraction units: a retrospective facility-based study in Malawi.International ophthalmology · 2026Article
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6 authors.
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No grant is acknowledged in the PubMed record.
Abstract
objectivesTo assess the association between varying levels of astigmatism and the likelihood of keratoconus diagnosis in adolescents.
methodsThis cross-sectional study included 896,377 adolescents aged 16-20 years who underwent a standardised medical assessment between 2011 and 2022, including refraction and topography/tomography in cases where astigmatism above 2.00 dioptres (D) was observed. Astigmatism was categorised into five groups: None, 0.75- < 2.00 D, 2.00- < 3.00 D, 3.00- < 5.00 D, and ≥5.00 D. Logistic regression models were used to assess the association between astigmatism and keratoconus diagnosis. Receiver Operating Characteristic (ROC) curve analysis was performed to evaluate the discriminatory ability of cylinder power in detecting keratoconus.
resultsOverall, 1886 adolescents (0.21%) were diagnosed with keratoconus. Increasing astigmatism levels were strongly associated with higher keratoconus prevalence, rising from 0.1% for 0.75- < 2.00 D to 17.4% for ≥5.00 D (p < 0.001). Each 1-diopter increase in cylinder power above 2.00 D was linked to a 1.76-fold increase in keratoconus odds (OR = 1.76, 95% CI: 1.70-1.82, p < 0.001). Astigmatism axis demonstrated limited discriminatory ability. ROC analysis showed moderate discriminatory power for cylinder power (AUC = 0.752), with a cut-off of 2.88 D yielding a sensitivity of 0.744 and a specificity of 0.644.
conclusionsIn this large cohort of adolescents, increasing astigmatism power was significantly associated with keratoconus diagnosis. These findings suggest that combining astigmatism thresholds with other clinical factors may enhance screening strategies, enabling timely intervention to prevent disease progression.
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