Prevalence of Keratoconus in a Population-Based Study in Syria.

Aim: To determine the prevalence and associations of keratoconus (KC) in a university student population in Syria. Methods: A prospective multicentre cross-sectional cohort study was conducted at two universities in Syria. Student volunteers were recruited from Tishreen University (Latakia governorate) and Damascus University (Damascus governorate). All participants underwent a comprehensive ocular examination. Placido/Scheimpflug-based corneal imaging using the Sirius (CSO, Florence. Italy), and a questionnaire to evaluate the baseline characteristics and medical history, as well as to highlight possible risk factors of KC. Univariate and bivariate analyses were performed. Results: The estimated prevalence of KC among all subjects was 1.43% (n = 12). A strong association between eye rubbing and keratoconus was found (OR 9.33, 95% CI 2.94-29.63, P < 0.001). Damascus University participants had a higher prevalence of KC than Tishreen University. However, the difference was not statistically significant. Conclusion: The prevalence of keratoconus in this Syrian student population was 1.43%. The results of this study demonstrate a high prevalence of keratoconus in the study population. Early detection of keratoconus through screening may yield benefits in preventing devastating sequelae of KC in populations with a high prevalence.

Leakage of Fluorescein Angiography Secondary to Rhegmatogenous Retinal Detachment: A Case Report.

The identification and evaluation of leaking areas in FA pictures are essential steps in the diagnostic process as well as the treatment and management of a variety of choroidal and retinal illnesses. We reported a case of rhegmatogenous retinal detachment in a seven-year-old boy with positive leakage on FA, which confused the presentation. A thorough contact lens examination and scleral indentation are mandatory to reach the diagnosis easily.

Prevalence of Keratoconus and Keratoconus Suspect among Patients Seeking Refractive Surgery in Syria.

PURPOSE: The purpose of this study was to determine the prevalence of keratoconus (KC) and keratoconus suspect (KCS) among patients seeking refractive surgery in Syria. METHODS: This is a retrospective multicenter screening study. The study was conducted in Damascus University, Tishreen University, and Tartous Specialist Eye Center (a private center). Data were collected from refractive surgery candidates referred for preoperative evaluation before laser in situ keratomileusis, photorefractive keratectomy, intrastromal corneal rings, and phakic intraocular lens implantation. Corneal parameters were obtained by Scheimpflug-Placido tomography, Sirius (CSO, Italy). RESULTS: A total of 1479 patients were included in this analysis. The prevalence rates of KC and KCS were 18.19% (269/1479) and 13.52% (200/1479), respectively. In addition, patients with KC were found to have higher percentages of eye rubbing and astigmatism than suspect and normal (P < 0.0001). CONCLUSION: High prevalence rate of KC was found among patients seeking refractive surgery in Syria. Although this study was carried out on a highly selective population, it may reflect a high prevalence rate in a general population in Syria.

Accelerated versus Standard Corneal Cross-linking for Progressive Keratoconus in Syria.

PURPOSE: To compare the outcomes of accelerated versus standard corneal cross-linking for the treatment of progressive keratoconus. METHODS: In this retrospective comparative study, 63 eyes of 40 patients with progressive keratoconus were divided into two groups; 27 eyes in group one were treated with an accelerated protocol (10 mW/cm 2 , 9 min) and 36 eyes in group two were treated with the standard method (3 mW/cm 2 , 30 min). Visual acuity, refraction, corneal topography, corneal tomography, and anterior and posterior corneal higher-order aberrations (HOAs) were assessed preoperatively and 18-30 months postoperatively. RESULTS: The LogMAR uncorrected and corrected distance visual acuity values were improved in both groups postoperatively. However, the improvement was significantly higher in group one (P < 0.05, all). The flattening in the anterior keratometry readings, flat K, steep K, and average K were significantly higher in group two (P < 0.001, all). The maximum anterior keratometry (AKf) values significantly decreased in both groups, whereas the maximum posterior keratometry (AKb) values increased. The reduction in the minimum corneal thickness (ThKmin) was significantly greater (36.49um) in group two, compared to 10.85um in group one. There was a significant increase in the posterior average keratometry, and a significant decrease in the posterior astigmatism, along 3 mm meridian in S-CXL (P = 0.03, P = 0.008, respectively), while the corresponding values showed no statistical significance in group one (P > 0.05). The anterior corneal trefoil was significantly reduced in group one (P = 0.002), whereas anterior total HOAs and coma were significantly improved in group two (P < 0.0014, all). The posterior corneal spherical aberration decreased significantly in group one (P = 0.02), while group two revealed significant reduction in the posterior trefoil values (P = 0.011). The change in the anterior maximum keratometry was significantly and positively correlated to the preoperative maximum keratometry in group two (P = 0.53, P = 0.003). CONCLUSION: An accelerated cross-linking protocol using 10 mW/cm 2 for 9 min showed more visual improvement and less pachymetric reduction when compared to the standard protocol, however, anterior corneal flattening, posterior corneal steepening, and the change in the posterior astigmatism were significantly higher in the standard protocol; while corneal HOAs were improved in both protocols.