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A cross-sectional study was carried out in Torrec\u00e1rdenas Hospital, Almer\u00eda, Spain, between February 2018 and July 2019. It included 250 keratoconus patients. Two groups were created according to a grading system of V.L. based on RETICS (Red Tem\u00e1tica de Investigaci\u00f3n Cooperativa en Salud) classification: keratoconus patients with no V.L. (best spectacle-corrected visual acuity (BSCVA)\u2009\u2264\u20090.05 logMAR) and keratoconus patients with V.L. (BSCVA\u2009&gt;\u20090.05 logMAR). Correlations and a binary logistic regression were established. V.L. was correlated with maximum curvature (<jats:italic>r<\/jats:italic>\u2009=\u20090.649, p\u2009&lt;\u20090.001) and root mean square higher-order aberrations (HOARMS) (<jats:italic>r<\/jats:italic>\u2009=\u20090.625, p\u2009&lt;\u20090.001). Binary logistic regression included V.L. as the dependent variable and spherical equivalent, HOARMS, spherical aberration and interaction between the anterior and posterior vertical coma as independent variables. The model was a good fit. Area under the curve (A.U.C.) of receiver operating characteristic (R.O.C.) curve was 0.924, sensitivity 91.90%, specificity 83.60%, accuracy 88.94%; and precision 91.17%. Binary logistic regression model of V.L. is a good fit model to predict the early loss of visual acuity in keratoconus patients.<\/jats:p>","DOI":"10.1038\/s41598-020-76489-1","type":"journal-article","created":{"date-parts":[[2020,11,9]],"date-time":"2020-11-09T11:05:02Z","timestamp":1604919902000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":5,"title":["A model of visual limitation in patients with keratoconus"],"prefix":"10.1038","volume":"10","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-2104-2907","authenticated-orcid":false,"given":"Antonio","family":"P\u00e9rez-Rueda","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gracia","family":"Castro-Luna","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2020,11,9]]},"reference":[{"key":"76489_CR1","doi-asserted-by":"publisher","first-page":"671","DOI":"10.1097\/00003226-200210000-00008","volume":"21","author":"K Zadnik","year":"2002","unstructured":"Zadnik, K., Fink, B., Nichols, J. 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