Progression and regression of keratoconus in an Iranian population

Abstract To evaluate temporal changes in keratoconus (KCN) in individuals of different ages. In this historical cohort study, participants diagnosed with KCN underwent two evaluations at separate time points. Each evaluation included corneal imaging using Pentacam-HR, ocular examinations, subjective...

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Main Authors: Alireza Jamali, Hassan Hashemi, Payam Nabovati, Mehdi Khabazkhoob
Format: Article
Language:English
Published: Nature Portfolio 2025-08-01
Series:Scientific Reports
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Online Access:https://doi.org/10.1038/s41598-025-08296-5
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author Alireza Jamali
Hassan Hashemi
Payam Nabovati
Mehdi Khabazkhoob
author_facet Alireza Jamali
Hassan Hashemi
Payam Nabovati
Mehdi Khabazkhoob
author_sort Alireza Jamali
collection DOAJ
description Abstract To evaluate temporal changes in keratoconus (KCN) in individuals of different ages. In this historical cohort study, participants diagnosed with KCN underwent two evaluations at separate time points. Each evaluation included corneal imaging using Pentacam-HR, ocular examinations, subjective refraction, and visual acuity assessments. KCN changes were defined as a minimum 1.00 D change in the anterior maximum keratometry (kmax), categorizing participants as regressive, stable, or progressive. A total of 838 participants (mean age 30.90 ± 8.30 years; 62.5% male) were assessed twice over an average follow-up period of 74.38 ± 42.21 months. Regression occurred in 81 eyes (mean Kmax change: -2.05 ± 1.27 D), progression in 196 eyes (mean Kmax change: +4.03 ± 4.58 D), and stability in 561 eyes (mean Kmax change: +0.07 ± 0.43 D); Cases of both progression and regression were observed across all 10-year age groups. At baseline, the regressive group had the highest corneal steepening, while the stable group had the least steepening (p < 0.05). The spherical equivalent was more negative in all three groups in the second examination except for those with ages more than 50 years (p < 0.05). Associations were observed between Kmax changes and male sex (β=-0.58; p = 0.013), posterior flat keratometry (β = 0.75; p < 0.001), posterior peripheral curvature (β=-1.91; p < 0.001), index of surface variance (β = 0.03; p < 0.001), keratoconus index (β = 4.04; p = 0.012), and minimum curvature (β = 1.05; p = 0.003). This study highlights that KCN can progress or regress at any age, challenging the traditional belief that it stabilizes in adulthood. The findings highlight the necessity of regular monitoring and individualized management strategies, particularly in cases where structural or visual changes may impact clinical decisions.
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spelling doaj-art-9d3439e2f5ea4a489d033dfd731860612025-08-20T03:42:36ZengNature PortfolioScientific Reports2045-23222025-08-0115111310.1038/s41598-025-08296-5Progression and regression of keratoconus in an Iranian populationAlireza Jamali0Hassan Hashemi1Payam Nabovati2Mehdi Khabazkhoob3Rehabilitation Research Center, Department of Optometry, School of Rehabilitation Sciences, Iran University of Medical SciencesNoor Ophthalmology Research Center, Noor Eye HospitalRehabilitation Research Center, Department of Optometry, School of Rehabilitation Sciences, Iran University of Medical SciencesDepartment of Medical Surgical Nursing, School of Nursing and Midwifery, Shahid Beheshti University of Medical SciencesAbstract To evaluate temporal changes in keratoconus (KCN) in individuals of different ages. In this historical cohort study, participants diagnosed with KCN underwent two evaluations at separate time points. Each evaluation included corneal imaging using Pentacam-HR, ocular examinations, subjective refraction, and visual acuity assessments. KCN changes were defined as a minimum 1.00 D change in the anterior maximum keratometry (kmax), categorizing participants as regressive, stable, or progressive. A total of 838 participants (mean age 30.90 ± 8.30 years; 62.5% male) were assessed twice over an average follow-up period of 74.38 ± 42.21 months. Regression occurred in 81 eyes (mean Kmax change: -2.05 ± 1.27 D), progression in 196 eyes (mean Kmax change: +4.03 ± 4.58 D), and stability in 561 eyes (mean Kmax change: +0.07 ± 0.43 D); Cases of both progression and regression were observed across all 10-year age groups. At baseline, the regressive group had the highest corneal steepening, while the stable group had the least steepening (p < 0.05). The spherical equivalent was more negative in all three groups in the second examination except for those with ages more than 50 years (p < 0.05). Associations were observed between Kmax changes and male sex (β=-0.58; p = 0.013), posterior flat keratometry (β = 0.75; p < 0.001), posterior peripheral curvature (β=-1.91; p < 0.001), index of surface variance (β = 0.03; p < 0.001), keratoconus index (β = 4.04; p = 0.012), and minimum curvature (β = 1.05; p = 0.003). This study highlights that KCN can progress or regress at any age, challenging the traditional belief that it stabilizes in adulthood. The findings highlight the necessity of regular monitoring and individualized management strategies, particularly in cases where structural or visual changes may impact clinical decisions.https://doi.org/10.1038/s41598-025-08296-5KeratoconusCorneaProgressionRegressionAge
spellingShingle Alireza Jamali
Hassan Hashemi
Payam Nabovati
Mehdi Khabazkhoob
Progression and regression of keratoconus in an Iranian population
Scientific Reports
Keratoconus
Cornea
Progression
Regression
Age
title Progression and regression of keratoconus in an Iranian population
title_full Progression and regression of keratoconus in an Iranian population
title_fullStr Progression and regression of keratoconus in an Iranian population
title_full_unstemmed Progression and regression of keratoconus in an Iranian population
title_short Progression and regression of keratoconus in an Iranian population
title_sort progression and regression of keratoconus in an iranian population
topic Keratoconus
Cornea
Progression
Regression
Age
url https://doi.org/10.1038/s41598-025-08296-5
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AT hassanhashemi progressionandregressionofkeratoconusinaniranianpopulation
AT payamnabovati progressionandregressionofkeratoconusinaniranianpopulation
AT mehdikhabazkhoob progressionandregressionofkeratoconusinaniranianpopulation