{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,1]],"date-time":"2026-08-01T08:07:01Z","timestamp":1785571621099,"version":"3.56.0"},"reference-count":68,"publisher":"Wiley","issue":"7","license":[{"start":{"date-parts":[[2024,5,14]],"date-time":"2024-05-14T00:00:00Z","timestamp":1715644800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Acta Ophthalmologica"],"published-print":{"date-parts":[[2024,11]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Purpose<\/jats:title><jats:p>To identify potential factors associated with keratoconus.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>This cross\u2010sectional study included data from Israel's largest healthcare provider for the years 2005\u20132020. Keratoconus patients and age\u2010matched controls were identified. Demographic factors and comorbid conditions, including smoking, diabetes mellitus, asthma, myalgia, mental retardation, Down syndrome, atopic dermatitis and allergy\/allergic rhinitis, were compared between the two cohorts. The independent risk factors associated with keratoconus were determined using a multivariable conditional logistic regression model.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Overall, 145\u2009508 subjects were reviewed of which 13\u2009228 were keratoconus patients. A ten\u2010fold group (<jats:italic>n<\/jats:italic>\u2009=\u2009132\u2009280) of age\u2010matched control subjects served as controls for comparisons. In multivariable analysis, several factors were found to be significantly associated with keratoconus. Male gender (OR\u2009=\u20091.27, <jats:italic>p<\/jats:italic>\u2009&lt;\u20090.001), Arab ethnicity (OR\u2009=\u20091.50, <jats:italic>p<\/jats:italic>\u2009&lt;\u20090.001), diabetes (OR\u2009=\u20091.19, <jats:italic>p<\/jats:italic>\u2009&lt;\u20090.001), asthma (OR\u2009=\u20091.50, <jats:italic>p<\/jats:italic>\u2009&lt;\u20090.001), myalgia (OR\u2009=\u20091.09, <jats:italic>p<\/jats:italic>\u2009=\u20090.02), mental retardation (OR\u2009=\u20092.63, <jats:italic>p<\/jats:italic>\u2009&lt;\u20090.001), atopic dermatitis (OR\u2009=\u20091.35, <jats:italic>p<\/jats:italic>\u2009&lt;\u20090.001) and allergic rhinitis (OR\u2009=\u20091.21, <jats:italic>p<\/jats:italic>\u2009&lt;\u20090.001) were significantly associated with keratoconus. Smoking was significantly protective of keratoconus (OR\u2009=\u20090.66, <jats:italic>p<\/jats:italic>\u2009&lt;\u20090.001).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>This population\u2010based study reports male gender, Arab ethnicity, diabetes, asthma, myalgia, mental retardation\/Down syndrome, atopic dermatitis and allergic rhinitis as factors associated with keratoconus while smoking demonstrates a protective effect. The results of this study could guide enhanced screening strategies and early interventions, particularly for high\u2010risk groups.<\/jats:p><\/jats:sec>","DOI":"10.1111\/aos.16706","type":"journal-article","created":{"date-parts":[[2024,5,14]],"date-time":"2024-05-14T13:57:01Z","timestamp":1715695021000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":6,"title":["Factors associated with keratoconus in Israel\u2014A cross\u2010sectional population\u2010based study"],"prefix":"10.1111","volume":"102","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-9812-3110","authenticated-orcid":false,"given":"Or","family":"Ben\u2010Shaul","sequence":"first","affiliation":[{"name":"Department of Ophthalmology Lady Davis Carmel Medical Center  Haifa Israel"},{"name":"Ruth and Bruce Rappaport Faculty of Medicine Technion\u2010Israel Institute of Technology  Haifa 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