TY - JOUR
T1 - Risk factors for keratoconus in Israel
T2 - A case-control study
AU - Gordon-Shaag, Ariela
AU - Millodot, Michel
AU - Kaiserman, Igor
AU - Sela, Tzahi
AU - Barnett Itzhaki, Guy
AU - Zerbib, Yaffa
AU - Matityahu, Efrat
AU - Shkedi, Shira
AU - Miroshnichenko, Svetlana
AU - Shneor, Einat
N1 - Publisher Copyright:
& Physiological Optics.
PY - 2015/11/1
Y1 - 2015/11/1
N2 - Purpose: Keratoconus (KC) is a progressive corneal thinning disorder with an uncertain aetiology. Environmental and genetic factors, including consanguinity, eye rubbing and possibly sun exposure, play a role in the aetiology of KC. Here we test for risk factors for KC in an Israeli population with particular emphasis on sun exposure. Methods: This case-control study included KC patients who were diagnosed at Care Laser Medical Group, a refractive surgery clinic with branches throughout Israel. The control group included age, sex and ethnicity matched individuals who were randomly selected from patients presenting at the clinic for refractive surgery, but without KC. Study subjects were asked to fill out a self-administered questionnaire that included demographic and geographic details, questions on ocular and general health and sun exposure. Conditional logistic regression was used to analyse univariable and multivariable data to identify risk factors for KC. Results: Seventy-three KC patients and 146 controls participated in the study. Univariable analyses demonstrated that eye rubbing [odds ratio (OR) = 3.76], positive family history of KC (OR = 6.10) and parents' education (<12 years, OR = 0.27, 0.23 for father's and mother's education respectively) were significant risk factors for KC. Univariable analyses of sun exposure behaviour during teenage years proved equivocal with some behaviours emerging as protective for KC (wearing a hat outdoors, OR = 3.13) or as risk factors (spending time in the shade, OR = 0.45), while others showed no association [limiting time in the sun (p = 0.51), and wearing sunglasses (p = 0.20)]. Most of the factors that were significant in the univariable analyses, also emerged as statistically significant in the multivariable model (OR = 3.37, 9.68, 0.35, 5.51 for eye rubbing, family history, parental education, wearing a hat outdoors, with the exception of spending time in the shade (p = 0.88). Conclusions: Eye rubbing, parents' education (as a measure of socio-economic status) and having family members with KC emerged as significant risk factors for KC. The role of sun exposure in KC remains equivocal and warrants further research.
AB - Purpose: Keratoconus (KC) is a progressive corneal thinning disorder with an uncertain aetiology. Environmental and genetic factors, including consanguinity, eye rubbing and possibly sun exposure, play a role in the aetiology of KC. Here we test for risk factors for KC in an Israeli population with particular emphasis on sun exposure. Methods: This case-control study included KC patients who were diagnosed at Care Laser Medical Group, a refractive surgery clinic with branches throughout Israel. The control group included age, sex and ethnicity matched individuals who were randomly selected from patients presenting at the clinic for refractive surgery, but without KC. Study subjects were asked to fill out a self-administered questionnaire that included demographic and geographic details, questions on ocular and general health and sun exposure. Conditional logistic regression was used to analyse univariable and multivariable data to identify risk factors for KC. Results: Seventy-three KC patients and 146 controls participated in the study. Univariable analyses demonstrated that eye rubbing [odds ratio (OR) = 3.76], positive family history of KC (OR = 6.10) and parents' education (<12 years, OR = 0.27, 0.23 for father's and mother's education respectively) were significant risk factors for KC. Univariable analyses of sun exposure behaviour during teenage years proved equivocal with some behaviours emerging as protective for KC (wearing a hat outdoors, OR = 3.13) or as risk factors (spending time in the shade, OR = 0.45), while others showed no association [limiting time in the sun (p = 0.51), and wearing sunglasses (p = 0.20)]. Most of the factors that were significant in the univariable analyses, also emerged as statistically significant in the multivariable model (OR = 3.37, 9.68, 0.35, 5.51 for eye rubbing, family history, parental education, wearing a hat outdoors, with the exception of spending time in the shade (p = 0.88). Conclusions: Eye rubbing, parents' education (as a measure of socio-economic status) and having family members with KC emerged as significant risk factors for KC. The role of sun exposure in KC remains equivocal and warrants further research.
KW - Case-control
KW - Cornea
KW - Epidemiology
KW - Keratoconus
UR - http://www.scopus.com/inward/record.url?scp=84946481326&partnerID=8YFLogxK
U2 - 10.1111/opo.12237
DO - 10.1111/opo.12237
M3 - Article
AN - SCOPUS:84946481326
VL - 35
SP - 673
EP - 681
JO - Ophthalmic and Physiological Optics
JF - Ophthalmic and Physiological Optics
SN - 0275-5408
IS - 6
ER -