| ORIGINAL ARTICLE |
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| Year : 2020 | Volume
: 32
| Issue : 4 | Page : 343-348 |
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Keratoconus indices and their determinants in healthy eyes of a rural population
Hassan Hashemi1, Reza Pakzad2, Samira Heydarian3, AbbasAli Yekta4, Hadi Ostadimoghaddam5, Mahdi Mortazavi1, Shahroukh Ramin6, Mehdi Khabazkhoob7
1 Noor Research Center for Ophthalmic Epidemiology, Noor Eye Hospital, Tehran, Iran
2 Noor Ophthalmology Research Center, Noor Eye Hospital, Tehran, Iran
3 Department of Rehabilitation Sciences, School of Allied Medical Sciences, Mazandaran University of Medical Sciences, Sari, Iran
4 Department of Optometry, School of Paramedical Sciences, Mashhad University of Medical Sciences, Mashhad, Iran
5 Refractive Errors Research Center, Mashhad University of Medical Sciences, Mashhad, Iran
6 Department of Optometry, Shahid Beheshti University of Medical Sciences, Tehran, Iran
7 Department of Psychiatric Nursing and Management, School of Nursing and Midwifery, Shahid Beheshti University of Medical Sciences, Tehran, Iran
Correspondence Address:
Mehdi Khabazkhoob
Department of Psychiatric Nursing and Management, School of Nursing and Midwifery, Shahid Beheshti University of Medical Sciences, Tehran
Iran
 Source of Support: None, Conflict of Interest: None
DOI: 10.1016/j.joco.2019.10.003
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Purpose: To determine the distribution of keratoconus indices in a 5-93-year-old healthy eyes of a rural population in Iran.
Methods: In this cross-sectional study, multi-stage cluster sampling was applied to select subjects from two villages in the north and southwest of Iran. After obtaining informed consent, all subjects underwent ophthalmologic and optometric examinations. Corneal imaging by the Pentacam was done in subjects above 5 years between 9 a.m. and 2 p.m., at least 3 h after wakeup. All subjects who had abnormal keratoconus indices were excluded. Our main outcome was keratometry-flat (Kf), keratometry-steep (Ks), keratoconus index (KI), and central keratoconus index (CKI).
Results: The mean ± standard deviation of Kf, Ks, KI, and CKI was 43.12 ± 1.74, 44.25 ± 1.65, 1.02 ± 0.02, and 1.01 ± 0.01, respectively. According to multiple linear regression analysis, the mean index surface variance (ISV) (b: -1.367, P < 0.001), index vertical asymmetry (IVA) (b: -0.012, P < 0.001), KI (b: -0.011, P < 0.001), CKI (b: -0.001, P < 0.001), index height asymmetry (IHA) (b: -0.491, P: 0.005), and index height decentration (IHD) (b: -0.001, P < 0.001) were lower in men compared to women. Moreover, age had an indirect association with ISV (b: -0.030, P < 0.001) and average pachymetric progression index (RPI_avg) (b: -0.001, P < 0.001), and a direct association with KI, CKI, and IHA. Spherical equivalence had an indirect association with KI (b: -0.001, P < 0.001) and RPI_avg (b: -0.004, P < 0.001) and a direct association with CKI (b: 0.001, P < 0.001). Among all variables, sex had the greatest impact on ISV, IVA, KI, IHA, IHD, and minimum sagittal curvature.
Conclusions: The Keratoconus indices of our study were similar to other studies. Although age, living place, and type of refractive error were associated with some indices, sex was the strongest determinant of Keratoconus indices in a population of healthy eyes.
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