Survey on Patient Characteristics and Treatments in Initial Visit Patients with Keratoconus

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  • 円錐角膜外来の初診患者の背景及び治療内容に関する調査

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Abstract

<p>[Purpose] To investigate the background and treatment details in patients who visited our keratoconus outpatient clinic for the first time.</p><p>[Subjects and Methods] Subjects were the patients who had initially visited the Nagoya Eye Clinic between January and December 2019 and had been suspected of or diagnosed with keratoconus. We retrospectively investigated the purpose of the visit, the initial severity and corrected visual acuity (VA), and the treatments performed during the year. Keratoconus severity was classified using the Amsler Krumeich classification. If both eyes had keratoconus, the more severe one was used as the target eye.</p><p>[Results] A total of 336 patients (223 men and 113 women) were included and the average age was 34.9 ± 16.6 (range, 8-76) years. The percentages of the subjects with and without referrals were 51.2% and 48.8%, respectively. Regarding the purpose of the visit, referral from another hospital for a detailed examination to confirm the diagnosis of keratoconus had the highest percentage (28%), followed by a medical consultation requested by the patient for keratoconus treatment (15.2%) and consultation about rigid gas permeable contact lens (RGPCL) intolerance (13.4%). The average initial corneal refractive power was 48.11 ± 6.07 D. Patients' severity levels included stage 1 in 144 (43%) eyes, stage 2 in 78 eyes (23%) eyes, stage 3 in 10 (3%) eyes, and stage 4 in 104 (31%) eyes. The average corrected VA (logMAR) was 0.17 ± 0.42 (decimal VA of 0.68). As for treatment decision, observation had the highest percentage （27.1％）and was followed by corneal cross-linking (CXL, 25.6%) and prescriptions for RGPCL (15.2%) and special contact lens such as scleral lenses (15.2%).</p><p>[Conclusion] A large portion of Keratoconus outpatients at our hospital had early stages of the disease and CXL was suitable in these cases. On the other hand, severe patients tended to have contact lens-related consultations more.</p>

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