Clinical Report: Keratoconus in Hormonal Flux

Overview

This systematic review highlights the significant role of hormonal fluctuations in the onset and progression of keratoconus (KCN). It emphasizes the need for clinicians to consider hormonal history in risk assessments and proposes targeted screening strategies for vulnerable populations.

Background

Keratoconus is a progressive corneal ectasia that often leads to visual impairment and is frequently diagnosed late. Current understanding primarily focuses on factors like eye rubbing and genetic predisposition, while hormonal influences have been underexplored. Recognizing hormonal fluctuations as a potential risk factor could enhance screening and management strategies for at-risk individuals.

Data Highlights

Key Findings

• Hormonal shifts, particularly during pregnancy, are linked to KCN onset and progression.
• Elevated DHEAS levels were consistently reported in case-control studies comparing KCN patients to controls.
• Congenital hormonal abnormalities and exogenous hormone exposures also contribute to KCN risk.
• Altered levels of estrogens and gonadotropins are associated with KCN pathology.
• Clinicians should be vigilant during significant hormonal changes as potential windows of vulnerability for KCN.

Clinical Implications

Healthcare professionals should integrate hormonal history into keratoconus risk assessments, particularly for patients undergoing significant hormonal changes. Developing proactive screening pathways could improve early detection and management of KCN.

Conclusion

This review underscores the importance of considering hormonal influences in keratoconus management, advocating for enhanced screening strategies during periods of hormonal fluctuation.

References

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