{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,4,15]],"date-time":"2026-04-15T09:03:00Z","timestamp":1776243780794,"version":"3.50.1"},"reference-count":39,"publisher":"Elsevier BV","issue":"4","license":[{"start":{"date-parts":[[2026,4,1]],"date-time":"2026-04-01T00:00:00Z","timestamp":1775001600000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/www.elsevier.com\/tdm\/userlicense\/1.0\/"},{"start":{"date-parts":[[2026,4,1]],"date-time":"2026-04-01T00:00:00Z","timestamp":1775001600000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/www.elsevier.com\/legal\/tdmrep-license"},{"start":{"date-parts":[[2026,2,2]],"date-time":"2026-02-02T00:00:00Z","timestamp":1769990400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100011919","name":"Universidade Federal do Estado do Rio de Janeiro","doi-asserted-by":"publisher","award":["58513822.4.0000.5258"],"award-info":[{"award-number":["58513822.4.0000.5258"]}],"id":[{"id":"10.13039\/501100011919","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["clinicalkey.com","clinicalkey.com.au","clinicalkey.es","clinicalkey.fr","clinicalkey.jp","ophthalmologyscience.org","elsevier.com","sciencedirect.com"],"crossmark-restriction":true},"short-container-title":["Ophthalmology Science"],"published-print":{"date-parts":[[2026,4]]},"DOI":"10.1016\/j.xops.2026.101109","type":"journal-article","created":{"date-parts":[[2026,2,6]],"date-time":"2026-02-06T16:36:09Z","timestamp":1770395769000},"page":"101109","update-policy":"https:\/\/doi.org\/10.1016\/elsevier_cm_policy","source":"Crossref","is-referenced-by-count":0,"title":["Prevalence and Risk Factors for Keratoconus in Young Adults Assessed with Tomography and Corneal Biomechanics: A Prospective Cross-Sectional Study"],"prefix":"10.1016","volume":"6","author":[{"given":"Lorena Santos","family":"Barros","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6233-096X","authenticated-orcid":false,"given":"Alexandre","family":"Batista da Costa Neto","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Louise Pellegrino G.","family":"Esporcatte","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Marcella Quaresma","family":"Salom\u00e3o","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0009-0003-4352-5763","authenticated-orcid":false,"given":"Bruno Frujuelli","family":"de Melo","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0009-0002-7948-154X","authenticated-orcid":false,"given":"Dillan Cunha","family":"Amaral","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9514-5744","authenticated-orcid":false,"given":"Renata A.","family":"Rezende","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2288-165X","authenticated-orcid":false,"given":"Mariana Lopes","family":"Souza","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"\u00c9rica Rossi","family":"Garcia","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Luca","family":"Gualdi","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Stephen D.","family":"Klyce","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Aydano","family":"Machado","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6919-4606","authenticated-orcid":false,"suffix":"Jr.","given":"Renato","family":"Ambr\u00f3sio","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"78","reference":[{"key":"10.1016\/j.xops.2026.101109_bib1","doi-asserted-by":"crossref","first-page":"297","DOI":"10.1016\/S0039-6257(97)00119-7","volume":"42","author":"Rabinowitz","year":"1998","journal-title":"Keratoconus Surv Ophthalmol"},{"key":"10.1016\/j.xops.2026.101109_bib2","doi-asserted-by":"crossref","first-page":"359","DOI":"10.1097\/ICO.0000000000000408","article-title":"Global consensus on keratoconus and ectatic diseases","volume":"34","author":"Gomes","year":"2015","journal-title":"Cornea"},{"key":"10.1016\/j.xops.2026.101109_bib3","doi-asserted-by":"crossref","DOI":"10.1016\/j.preteyeres.2021.101016","article-title":"Anterior pituitary, sex hormones, and keratoconus: beyond traditional targets","volume":"88","author":"Karamichos","year":"2022","journal-title":"Prog Retin Eye Res"},{"key":"10.1016\/j.xops.2026.101109_bib4","doi-asserted-by":"crossref","first-page":"2705","DOI":"10.2147\/OPTH.S392665","article-title":"Keratoconus diagnosis and treatment: recent advances and future directions","volume":"17","author":"Bui","year":"2023","journal-title":"Clin Ophthalmol"},{"key":"10.1016\/j.xops.2026.101109_bib5","doi-asserted-by":"crossref","first-page":"865","DOI":"10.2147\/OPTH.S451232","article-title":"Corneal collagen crosslinking for ectasia after refractive surgery: a systematic review and meta-analysis","volume":"18","author":"Amaral","year":"2024","journal-title":"Clin Ophthalmol"},{"key":"10.1016\/j.xops.2026.101109_bib6","doi-asserted-by":"crossref","first-page":"263","DOI":"10.1097\/ICO.0000000000002150","article-title":"The prevalence and risk factors for keratoconus: a systematic review and meta-analysis","volume":"39","author":"Hashemi","year":"2020","journal-title":"Cornea"},{"key":"10.1016\/j.xops.2026.101109_bib7","doi-asserted-by":"crossref","first-page":"267","DOI":"10.1016\/0002-9394(86)90817-2","article-title":"A 48-year clinical and epidemiologic study of keratoconus","volume":"101","author":"Kennedy","year":"1986","journal-title":"Am J Ophthalmol"},{"key":"10.1016\/j.xops.2026.101109_bib8","doi-asserted-by":"crossref","first-page":"1436","DOI":"10.1136\/bjophthalmol-2017-311391","article-title":"Prevalence of keratoconus in paediatric patients in Riyadh, Saudi Arabia","volume":"102","author":"Torres Netto","year":"2018","journal-title":"Br J Ophthalmol"},{"key":"10.1016\/j.xops.2026.101109_bib9","doi-asserted-by":"crossref","first-page":"117","DOI":"10.1097\/ICL.0000000000001066","article-title":"Prevalence of keratoconus among high school students in Southern Brazil: a community-based study","volume":"50","author":"de Azevedo Magalh\u00e3es","year":"2024","journal-title":"Eye Contact Lens"},{"key":"10.1016\/j.xops.2026.101109_bib10","doi-asserted-by":"crossref","DOI":"10.1097\/ICO.0000000000003973","article-title":"Global incidence and prevalence of keratoconus: A systematic review and meta-analysis","author":"Sriranganathan","year":"2025","journal-title":"Cornea"},{"key":"10.1016\/j.xops.2026.101109_bib11","doi-asserted-by":"crossref","first-page":"1213","DOI":"10.1016\/j.jcrs.2017.07.021","article-title":"New perspectives on the detection and progression of keratoconus","volume":"43","author":"Mart\u00ednez-Abad","year":"2017","journal-title":"J Cataract Refract Surg"},{"key":"10.1016\/j.xops.2026.101109_bib12","doi-asserted-by":"crossref","first-page":"99","DOI":"10.1590\/S0034-72802013000200005","article-title":"Dynamic ultra high speed Scheimpflug imaging for assessing corneal biomechanical properties","volume":"72","author":"Ambr\u00f3sio","year":"2013","journal-title":"Revista Brasileira de Oftalmologia"},{"key":"10.1016\/j.xops.2026.101109_bib13","doi-asserted-by":"crossref","first-page":"685","DOI":"10.1007\/s40123-020-00283-5","article-title":"Violet June: the global keratoconus awareness campaign","volume":"9","author":"Ambrosio","year":"2020","journal-title":"Ophthalmol Ther"},{"key":"10.1016\/j.xops.2026.101109_bib14","doi-asserted-by":"crossref","first-page":"e20","DOI":"10.1097\/ICO.0000000000000500","article-title":"Screening for keratoconus and related ectatic corneal disorders","volume":"34","author":"Randleman","year":"2015","journal-title":"Cornea"},{"key":"10.1016\/j.xops.2026.101109_bib15","doi-asserted-by":"crossref","first-page":"e38","DOI":"10.1097\/ICO.0000000000000623","article-title":"Global consensus on keratoconus diagnosis","volume":"34","author":"Gomes","year":"2015","journal-title":"Cornea"},{"key":"10.1016\/j.xops.2026.101109_bib16","doi-asserted-by":"crossref","first-page":"126","DOI":"10.1016\/j.ajo.2022.12.016","article-title":"Optimized artificial intelligence for enhanced ectasia detection using scheimpflug-based corneal tomography and biomechanical data","volume":"251","author":"Ambr\u00f3sio","year":"2023","journal-title":"Am J Ophthalmol"},{"key":"10.1016\/j.xops.2026.101109_bib17","author":"Correia"},{"issue":"5 Suppl","key":"10.1016\/j.xops.2026.101109_bib18","first-page":"S617","article-title":"Screening patients with the corneal navigator","volume":"21","author":"Klyce","year":"2005","journal-title":"J Refract Surg"},{"key":"10.1016\/j.xops.2026.101109_bib19","doi-asserted-by":"crossref","first-page":"45","DOI":"10.1186\/s40662-023-00363-0","article-title":"Multimodal diagnostics for keratoconus and ectatic corneal diseases: a paradigm shift","volume":"10","author":"Ambrosio","year":"2023","journal-title":"Eye Vis (Lond)"},{"key":"10.1016\/j.xops.2026.101109_bib20","doi-asserted-by":"crossref","first-page":"3238","DOI":"10.3390\/jcm10153238","article-title":"Forecasting progressive trends in keratoconus by means of a time delay neural network","volume":"10","author":"Jim\u00e9nez-Garc\u00eda","year":"2021","journal-title":"J Clin Med"},{"key":"10.1016\/j.xops.2026.101109_bib21","doi-asserted-by":"crossref","first-page":"173","DOI":"10.1038\/s41433-020-1039-1","article-title":"A review of imaging modalities for detecting early keratoconus","volume":"35","author":"Zhang","year":"2021","journal-title":"Eye (Lond)"},{"key":"10.1016\/j.xops.2026.101109_bib22","article-title":"Performances of corneal topography and tomography in the diagnosis of subclinical and clinical keratoconus","volume":"9","author":"Nicula","year":"2022","journal-title":"Front Med (Lausanne)"},{"key":"10.1016\/j.xops.2026.101109_bib23","doi-asserted-by":"crossref","first-page":"1025","DOI":"10.1097\/ICO.0000000000001639","article-title":"Diagnostic ability of corneal shape and biomechanical parameters for detecting frank keratoconus","volume":"37","author":"Sedaghat","year":"2018","journal-title":"Cornea"},{"key":"10.1016\/j.xops.2026.101109_bib24","doi-asserted-by":"crossref","first-page":"107","DOI":"10.1016\/j.ophtha.2023.07.030","article-title":"Advanced corneal imaging in keratoconus: a report by the American Academy of ophthalmology","volume":"131","author":"Kuo","year":"2024","journal-title":"Ophthalmology"},{"key":"10.1016\/j.xops.2026.101109_bib25","doi-asserted-by":"crossref","first-page":"1665","DOI":"10.1038\/s41433-022-02218-9","article-title":"Detection ability of corneal biomechanical parameters for early diagnosis of ectasia","volume":"37","author":"Sedaghat","year":"2023","journal-title":"Eye (Lond)"},{"key":"10.1016\/j.xops.2026.101109_bib26","article-title":"Screening of sensitive","volume":"11","author":"Chen","year":"2023","journal-title":"Front Bioeng Biotechnol"},{"key":"10.1016\/j.xops.2026.101109_bib27","doi-asserted-by":"crossref","first-page":"9","DOI":"10.1186\/s40662-020-0174-x","article-title":"Biomechanical diagnostics of the cornea","volume":"7","author":"Esporcatte","year":"2020","journal-title":"Eye Vis (Lond)"},{"key":"10.1016\/j.xops.2026.101109_bib28","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1080\/17469899.2025.2594819","article-title":"The power of predictive artificial intelligence for the detection of ectasia","volume":"20","author":"Esporcatte","year":"2025","journal-title":"Expert Rev Ophthalmol"},{"key":"10.1016\/j.xops.2026.101109_bib29","doi-asserted-by":"crossref","first-page":"223","DOI":"10.1016\/j.ajo.2018.08.005","article-title":"Enhanced tomographic assessment to detect corneal ectasia based on artificial intelligence","volume":"195","author":"Lopes","year":"2018","journal-title":"Am J Ophthalmol"},{"key":"10.1016\/j.xops.2026.101109_bib30","doi-asserted-by":"crossref","first-page":"1168","DOI":"10.1097\/j.jcrs.0000000000000946","article-title":"New artificial intelligence index based on Scheimpflug corneal tomography to distinguish subclinical keratoconus from healthy corneas","volume":"48","author":"Almeida","year":"2022","journal-title":"J Cataract Refract Surg"},{"key":"10.1016\/j.xops.2026.101109_bib31","doi-asserted-by":"crossref","first-page":"736","DOI":"10.1111\/opo.12825","article-title":"Keratoconus in Africa: a systematic review and meta-analysis","volume":"41","author":"Akowuah","year":"2021","journal-title":"Ophthalmic Physiol Opt"},{"key":"10.1016\/j.xops.2026.101109_bib32","doi-asserted-by":"crossref","first-page":"1382","DOI":"10.1097\/ICO.0000000000002054","article-title":"Keratoconus prevalence among high school students in New Zealand","volume":"38","author":"Papali'i-Curtin","year":"2019","journal-title":"Cornea"},{"key":"10.1016\/j.xops.2026.101109_bib33","doi-asserted-by":"crossref","first-page":"23","DOI":"10.1016\/j.jfo.2011.03.016","article-title":"Keratoconus screening in a Lebanese students' population","volume":"35","author":"Waked","year":"2011","journal-title":"J francais d'ophtalmologie"},{"key":"10.1016\/j.xops.2026.101109_bib34","doi-asserted-by":"crossref","first-page":"515","DOI":"10.1016\/j.ophtha.2020.08.020","article-title":"Prevalence of keratoconus based on Scheimpflug imaging: the Raine study","volume":"128","author":"Chan","year":"2021","journal-title":"Ophthalmology"},{"key":"10.1016\/j.xops.2026.101109_bib35","doi-asserted-by":"crossref","DOI":"10.1016\/j.clae.2023.101846","article-title":"The prevalence of keratoconus in northern Poland: a cross-sectional study of patients from a primary healthcare practice","volume":"46","author":"Kanclerz","year":"2023","journal-title":"Contact Lens and Anterior Eye"},{"key":"10.1016\/j.xops.2026.101109_bib36","doi-asserted-by":"crossref","first-page":"900","DOI":"10.1186\/s12913-025-13020-0","article-title":"Gender differences in health-seeking behaviour: insights from the National Health and Morbidity Survey 2019","volume":"25","author":"Rata Mohan","year":"2025","journal-title":"BMC Health Serv Res"},{"key":"10.1016\/j.xops.2026.101109_bib37","doi-asserted-by":"crossref","first-page":"132","DOI":"10.1080\/02813432.2023.2191653","article-title":"Sex and gender differences in primary care help-seeking for common somatic symptoms: a longitudinal study","volume":"41","author":"Ballering","year":"2023","journal-title":"Scand J Prim Health Care"},{"key":"10.1016\/j.xops.2026.101109_bib38","doi-asserted-by":"crossref","DOI":"10.1371\/journal.pone.0180009","article-title":"A cross-sectional study of sociodemographic factors and their influence on quality of life in medical students at Sao Paulo, Brazil","volume":"12","author":"Serinolli","year":"2017","journal-title":"PLoS One"},{"key":"10.1016\/j.xops.2026.101109_bib40","article-title":"Controversies in the Management of Keratoconus","year":"2019"}],"container-title":["Ophthalmology Science"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/api.elsevier.com\/content\/article\/PII:S2666914526000473?httpAccept=text\/xml","content-type":"text\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/api.elsevier.com\/content\/article\/PII:S2666914526000473?httpAccept=text\/plain","content-type":"text\/plain","content-version":"vor","intended-application":"text-mining"}],"deposited":{"date-parts":[[2026,4,15]],"date-time":"2026-04-15T08:19:03Z","timestamp":1776241143000},"score":1,"resource":{"primary":{"URL":"https:\/\/linkinghub.elsevier.com\/retrieve\/pii\/S2666914526000473"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,4]]},"references-count":39,"journal-issue":{"issue":"4","published-print":{"date-parts":[[2026,4]]}},"alternative-id":["S2666914526000473"],"URL":"https:\/\/doi.org\/10.1016\/j.xops.2026.101109","relation":{},"ISSN":["2666-9145"],"issn-type":[{"value":"2666-9145","type":"print"}],"subject":[],"published":{"date-parts":[[2026,4]]},"assertion":[{"value":"Elsevier","name":"publisher","label":"This article is maintained by"},{"value":"Prevalence and Risk Factors for Keratoconus in Young Adults Assessed with Tomography and Corneal Biomechanics: A Prospective Cross-Sectional Study","name":"articletitle","label":"Article Title"},{"value":"Ophthalmology Science","name":"journaltitle","label":"Journal Title"},{"value":"https:\/\/doi.org\/10.1016\/j.xops.2026.101109","name":"articlelink","label":"CrossRef DOI link to publisher maintained version"},{"value":"article","name":"content_type","label":"Content Type"},{"value":"\u00a9 2026 American Academy of Ophthalmology. Published by Elsevier Inc.","name":"copyright","label":"Copyright"}],"article-number":"101109"}}