Keratoconus in children in Tunisia: Epidemiological, clinical and therapeutic features

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Published Jan 2, 2025
https://doi.org/10.62438/tunismed.v103i1.5361
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Vol. 103 No. 1 (2025): Tunis Med Jan 2025

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Sonda Kammoun
Department of Ophtalmology, Habib Bourguiba University Hospital, University of Sfax, Sfax, Tunisia
Kmar Maaloul
Department of Ophtalmology, Habib Bourguiba University Hospital, University of Sfax, Sfax, Tunisia
https://orcid.org/0000-0001-9256-9197
Mona Rekik
Department of Ophtalmology, Habib Bourguiba University Hospital, University of Sfax, Sfax, Tunisia
Karim Chaabouni
Department of Ophtalmology, Habib Bourguiba University Hospital, University of Sfax, Sfax, Tunisia
Amira Trigui
Department of Ophtalmology, Habib Bourguiba University Hospital, University of Sfax, Sfax, Tunisia

Abstract

Aim: To report the clinical and therapeutic particularities of pediatric keratoconus (KC).


Methods: Retrospective study focusing on patients aged less than 18 years, presenting with KC and followed in a tertiary reference center in Sfax, Tunisia.


Results: Our study involved 38 eyes of 20 children. We found a mean age of 12.8 years, a family history of keratoconus for 25% of cases and an atopic background in 30% of children. The mean best-corrected visual acuity was 5.3/10, the mean myopia was -6.3D and the mean total astigmatism was -4.9D. The average maximum simulated keratometry (Kmax) was 54.6 D. The visual acuity decrease was correlated with the presence of corneal opacities, with all keratometric indices except Skewed Radial Axes (SRAX) at 3 and 5 mm, with all elevation parameters and those of pachymetry except the delocalization of the thinnest point. 71.1% of eyes were classified as clinical KC and 47% of eyes were classified as Amlser-Krumeich stage 4. 42.1% of eyes were fitted with glasses and 57.9% with contact lenses. Six patients (10 eyes) underwent cross-linking (CXL). We noted an evolution of the KC for 64.29% of eyes not treated with CXL and a stabilization of 80% of eyes treated with CXL. The difference in follow-up parameters between the two groups was significant.


Conclusion: Pediatric KC is a severe disease, often diagnosed at a late stage. CXL is a safe and effective way to stop the disease.

Keywords:

Keratoconus, Child, Corneal topography, Cross-linking

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