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Member Research & Reports

Member Research & Reports

Michigan Team Reports on Largest-ever Study of Cornea Condition Reveals Hidden Risk Factors

A large new study reveals previously unknown risk factors associated with an eye condition that causes serious progressive nearsightedness at a relatively young age.

[Photo: Dr. Joshua Stein]

The findings, made through the largest-ever clinical study of the condition called keratoconus, could help more people receive newer treatments that can slow the problem and protect their vision.

Keratoconus makes the rounded, clear covering of the eye, called the cornea, weak, which leads it to become cone-shaped over time. The last decade has brought new treatment options, but many people do not receive a diagnosis early enough to take full advantage of them.

The new study shows that men, African-Americans and Latinos, and people with asthma, sleep apnea or Down syndrome, have much higher odds of developing keratoconus. But females, Asian-Americans and people with diabetes appear to have a lower risk, the analysis shows.

The findings, made by researchers at the University of Michigan are published online ahead of print in the journal Ophthalmology.

The research was sparked by questions whether changes to the eye with keratoconus affect other parts of the body. Studying eye conditions’ associations with other health conditions is easier now because of vast data troves.

“Eye health relates to total body health, and we as ophthalmologists need to be aware of more than just eyeballs when we see patients,” says Dr. Maria Woodward, an assistant professor of ophthalmology at the U-M Medical School and first author of the new study. Dr. Joshua Stein, an associate professor of public health and ophthalmology was a co-author on the study.

Patients with keratoconus and their families, as well as physicians, should be aware of other potential health problems uncovered in the study, the authors say.

Associations uncovered – or not

The researchers made their findings by looking at data from health insurance claims, half of them from more than 16,000 people with confirmed keratoconus and half from an equal number of people with similar characteristics but no keratoconus.

This allowed them to see which characteristics and medical conditions were most associated with keratoconus, and which were not. The people in the study were mostly in their 30s and 40s.

The study helps confirm many suspicions about the condition raised by previous small studies – but casts doubt on others. For instance, men were already known to have a higher risk, which the study confirmed.

And people with Down syndrome had a much higher chance of having keratoconus – six times higher than others – a known risk but still a stark one. This reinforces the high importance of screening and treatment for the condition in members of the Down syndrome community, starting at a young age, Woodward says.

But the higher rates of keratoconus among people of African American and Latino origin – 50 percent higher than Whites — were previously unknown. And the finding of a 39 percent lower rate among people of Asian heritage contradicts previous research.

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