Progressive corneal ectatic disease in pregnancy.

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dc.contributor.author Jani, Devanshi
dc.contributor.author McKelvie, James
dc.contributor.author Misra, Stuti L
dc.coverage.spatial United States
dc.date.accessioned 2021-09-19T21:41:40Z
dc.date.available 2021-09-19T21:41:40Z
dc.date.issued 2021-8-12
dc.identifier.issn 0816-4622
dc.identifier.uri https://hdl.handle.net/2292/56579
dc.description.abstract Pregnancy influences ocular changes which may exacerbate existing or develop new pathology. This review summarises the existing evidence on the association between pregnancy and progressive keratoconus or iatrogenic keratectasia. Ten online databases were searched systematically. Eligible studies were published in English and reported objective ophthalmic outcomes for women with evidence of (i) a new diagnosis of keratoconus, (ii) keratoconus progression or (iii) iatrogenic keratectasia following refractive surgery; during or within one year of pregnancy. Strength of evidence was assessed using the Oxford Centre for Evidence-Based Medicine levels of evidence. Seventeen articles have reported 33 peripartum women with new-onset or progressive ectasia, evident by signs of corneal hydrops or protrusion (n = 8); steepening on topography imaging (n = 20); a mean decline in best corrected visual acuity by +0.20 logMAR (95% CI -0.01 to +0.40, n = 23); a mean increase in maximum keratometry by 2.18 D (95% CI 1.44 to 2.91, n = 42); a mean decline in spherical equivalent refraction by -1.33 D (95% CI -1.73 to -0.93, n = 41); and a mean increase in astigmatism by -1.61 D (95% CI -2.46 to -0.75, n = 19). Pregnancy is associated with progressive ectasia in some women including those with previously stable keratoconus, or a history of laser-assisted in situ keratomileusis surgery or no history of corneal ectasia. This review highlights the heterogeneity in limited existing evidence, the need for a standardised definition of ectasia progression and further prospective studies for clinical guidelines. Closely monitoring women at risk may assist in early intervention with collagen cross-linking and prevent peripartum vision loss.
dc.language eng
dc.publisher Informa UK Limited
dc.relation.ispartofseries Clin Exp Optom
dc.rights Items in ResearchSpace are protected by copyright, with all rights reserved, unless otherwise indicated. Previously published items are made available in accordance with the copyright policy of the publisher.
dc.rights.uri https://researchspace.auckland.ac.nz/docs/uoa-docs/rights.htm
dc.subject Iatrogenic keratectasia
dc.subject Keratoconus
dc.subject cornea
dc.subject ectasia
dc.subject pregnancy
dc.subject 02 Physical Sciences
dc.subject 11 Medical and Health Sciences
dc.title Progressive corneal ectatic disease in pregnancy.
dc.type Journal Article
dc.identifier.doi 10.1080/08164622.2021.1924627
pubs.begin-page 1
dc.date.updated 2021-08-17T12:10:20Z
dc.rights.holder Copyright: The author en
pubs.author-url https://www.ncbi.nlm.nih.gov/pubmed/34384340
pubs.end-page 12
pubs.publication-status Published online
dc.rights.accessrights http://purl.org/eprint/accessRights/RetrictedAccess en
pubs.subtype Journal Article
pubs.elements-id 863236
dc.identifier.eissn 1444-0938
pubs.online-publication-date 2021-8-12


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