{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,3]],"date-time":"2026-09-03T23:29:03Z","timestamp":1788478143728,"version":"build-2803163510"},"reference-count":31,"publisher":"Wiley","issue":"1","license":[{"start":{"date-parts":[[2023,11,14]],"date-time":"2023-11-14T00:00:00Z","timestamp":1699920000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100001511","name":"Auckland Medical Research Foundation","doi-asserted-by":"publisher","award":["1218001"],"award-info":[{"award-number":["1218001"]}],"id":[{"id":"10.13039\/501100001511","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Clinical Exper Ophthalmology"],"published-print":{"date-parts":[[2024,1]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Background<\/jats:title><jats:p>This study investigated the prevalence, risk factors and severity of corneal tomographic features of keratoconus in Down syndrome (DS). Additionally, previous studies indicate anomalous corneal features in DS, without keratoconus, this study characterised corneal features in DS without keratoconus.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>This prospective observational study included participants with DS \u226510\u2009years old. Keratoconus diagnosis, risk factors and corneal tomographic characteristics were recorded. Participants underwent slit\u2010lamp biomicroscopy, Scheimpflug corneal tomography, corneal topography and autorefraction. A diagnosis of keratoconus (DS\u2010KC), suspect keratoconus (DS\u2010SK) and non\u2010keratoconus (DS\u2010NK) was made based on expert review of scans by three fellowship trained anterior segment ophthalmologists. Corneal tomography parameters from one eye of each participant were analysed.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Keratoconus affected 50 (26.3%) of 190 participants, diagnosed by corneal tomography, topography or slit\u2010lamp signs. Corneal hydrops affected 14.0% of DS\u2010KC participants. Eye rubbing was a significant risk factor for keratoconus (p\u2009=\u20090.036). 175 (92%) participants could undertake corneal tomography of which tomography assessment alone identified 47 (26.9%) DS\u2010KC participants, 64 (36.6%) DS\u2010SK participants and 64 (36.6%) DS\u2010NK participants. Significant differences (<jats:italic>p<\/jats:italic>\u2009&lt;\u20090.001) were identified when the DS\u2010KC, DS\u2010SK and DS\u2010NK groups were compared in maximum keratometry and posterior elevation at the thinnest point respectively: median (interquartile range) 50.20 (10.30D), 47.60 (1.95D), 46.50 (2.40D); 24.0 (38.00\u2009\u03bcm), 10.00 (13.75\u2009\u03bcm), 8.00 (6.00\u2009\u03bcm). The DS\u2010SK and DS\u2010NK cohorts had similar minimum pachymetry, however, had several significantly different parameters among which included greater maximum keratometry, posterior elevation at the thinnest point in the DS\u2010SK group.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>Keratoconus is common in DS. Keratoconus screening with corneal tomography is recommended for early detection.<\/jats:p><\/jats:sec>","DOI":"10.1111\/ceo.14316","type":"journal-article","created":{"date-parts":[[2023,11,15]],"date-time":"2023-11-15T02:49:14Z","timestamp":1700016554000},"page":"22-30","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":9,"title":["Keratoconus in Down syndrome: Prevalence, risk factors, severity and corneal tomographic characteristics"],"prefix":"10.1111","volume":"52","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-5582-0338","authenticated-orcid":false,"given":"Joyce J.","family":"Mathan","sequence":"first","affiliation":[{"name":"Department of Ophthalmology New Zealand National Eye Centre, Faculty of Medical and Health Sciences, University of Auckland  Auckland New Zealand"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0643-9420","authenticated-orcid":false,"given":"Akilesh","family":"Gokul","sequence":"additional","affiliation":[{"name":"Department of Ophthalmology New Zealand National Eye Centre, Faculty of Medical and Health Sciences, University of Auckland  Auckland New Zealand"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4487-0636","authenticated-orcid":false,"given":"Samantha K.","family":"Simkin","sequence":"additional","affiliation":[{"name":"Department of Ophthalmology New Zealand National Eye Centre, Faculty of Medical and Health Sciences, University of Auckland  Auckland New Zealand"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jay J.","family":"Meyer","sequence":"additional","affiliation":[{"name":"Department of Ophthalmology New Zealand National Eye Centre, Faculty of Medical and Health Sciences, University of Auckland  Auckland New Zealand"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7048-0706","authenticated-orcid":false,"given":"Charles N. J.","family":"McGhee","sequence":"additional","affiliation":[{"name":"Department of Ophthalmology New Zealand National Eye Centre, Faculty of Medical and Health Sciences, University of Auckland  Auckland New Zealand"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2023,11,14]]},"reference":[{"key":"e_1_2_9_2_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jaapos.2020.02.004"},{"key":"e_1_2_9_3_1","doi-asserted-by":"publisher","DOI":"10.1002\/ajmg.a.61845"},{"key":"e_1_2_9_4_1","doi-asserted-by":"publisher","DOI":"10.1007\/s10384-020-00725-4"},{"key":"e_1_2_9_5_1","doi-asserted-by":"publisher","DOI":"10.1111\/ceo.13852"},{"key":"e_1_2_9_6_1","doi-asserted-by":"publisher","DOI":"10.1001\/jamanetworkopen.2021.0814"},{"key":"e_1_2_9_7_1","doi-asserted-by":"publisher","DOI":"10.1001\/jamaophthalmol.2018.2373"},{"key":"e_1_2_9_8_1","doi-asserted-by":"publisher","DOI":"10.1097\/ICO.0000000000002054"},{"key":"e_1_2_9_9_1","doi-asserted-by":"publisher","DOI":"10.1146\/annurev-vision-121219-081723"},{"key":"e_1_2_9_10_1","doi-asserted-by":"publisher","DOI":"10.1097\/00003226-199207000-00005"},{"key":"e_1_2_9_11_1","doi-asserted-by":"publisher","DOI":"10.1038\/sj.eye.6702692"},{"key":"e_1_2_9_12_1","doi-asserted-by":"publisher","DOI":"10.1136\/bjophthalmol-2019-314939"},{"key":"e_1_2_9_13_1","unstructured":"MathanJ.Keratoconus in down syndrome: prevalence assessment visual disability quality of life and Corneal cross linking [dissertation]. 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