Much higher prevalence of keratoconus than announced results of the Gutenberg Health Study (GHS)

Abstract

Keratoconus appears to be a rare corneal disease with a prevalence previously estimated at 1:2000. The aim of our study was to investigate the prevalence of keratoconus in a large German cohort and to evaluate possible associated factors. Method In the population-based, prospective, monocentric cohort study, Gutenberg Health Study, 12,423 subjects aged 40–80 years were examined at the 5-year follow-up. Subjects underwent a detailed medical history and a general and oph thalmologic examination including Scheimpfug imaging. Keratoconus diagnosis was performed in two steps: all subjects with conspicuous TKC analysis of corneal tomography were included in further grading. Prevalence and 95% confdence intervals were calculated. Logistic regression analysis was carried out to investigate associa tion with age, sex, BMI, thyroid hormone, smoking, diabetes, arterial hypertension, atopy, allergy, steroid use, sleep apnea, asthma, and depression. Results Of 10,419 subjects, 75 eyes of 51 subjects were classifed as having keratoconus. The prevalence for keratoconus in the German cohort was 0.49% (1:204; 95% CI: 0.36–0.64%) and was approximately equally distributed across the age decades. No gender predisposition could be demonstrated. Logistic regression showed no association between keratoconus and age, sex, BMI, thyroid hormone, smoking, diabetes, arterial hypertension, atopy, allergy, steroid use, sleep apnea, asthma, and depression in our sample. Conclusion The prevalence of keratoconus disease in a mainly Caucasian population is approximately tenfold higher than previously reported in the literature using latest technologies (Scheimpfug imaging). Contrary to previous assumptions, we did not fnd associations with sex, existing atopy, thyroid dysfunction, diabetes, smoking, and depression.