Abstract
PURPOSE: Keratoconus (KCN) is characterized by corneal thinning and bulging, leading to vision impairment. Assessing choroidal thickness (CT) in pediatric KCN ( pKCN) patients can provide insights for better understanding and managing the disease. CT may serve as a potential indicator of disease activity in KCN patients. This study aims to evaluate CT and retinal thickness (RT) in different stages of pKCN patients and compare the findings with an age-matched control group. METHODS AND PATIENTS: This cross-sectional study included patients under 18 years old who met specific criteria. CT and RT was measured in all subjects using an optical coherence tomography device (Spectralis OCT, version 6.0, Heidelberg Engineering, Germany) with enhanced depth imaging mode, without pupil dilation. Mean CT and RT in pKCN was compared with healthy subjects and assessed among different disease grades using the ABCD grading method. RESULTS: The study included 125 eyes (66 patients) in the pKCN group and 42 control eyes (21 individuals). Grade 2 KCN showed the highest prevalence at 26.4% (N = 33), while grades 3 and 1 had prevalence rates of 24% (N = 30). CT in all specified areas (all P-values < 0.001), as well as RT in the subfoveal area (P-value < 0.001) and 1500 μm nasal to the fovea (P-value = 0.025), were significantly greater in the pKCN group compared to controls. Furthermore, CT and RT differed significantly among the pKCN grades (P-values < 0.001). CONCLUSION: CT was found to be elevated in pKCN patients, similar to adult KCN cases. CT could potentially serve as a clinical marker for disease activity in pKCN; however, further studies are needed.