{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,5]],"date-time":"2026-06-05T05:27:42Z","timestamp":1780637262841,"version":"3.54.1"},"reference-count":36,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2021,11,24]],"date-time":"2021-11-24T00:00:00Z","timestamp":1637712000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100001809","name":"National Natural Science Foundation of China","doi-asserted-by":"publisher","award":["82171015"],"award-info":[{"award-number":["82171015"]}],"id":[{"id":"10.13039\/501100001809","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Med."],"abstract":"<jats:p><jats:bold>Purpose:<\/jats:bold> To evaluate corneal elevation changes in patients with allergic conjunctivitis (AC) and to analyze their correlations with ocular allergy signs and corneal biomechanical alterations.<\/jats:p><jats:p><jats:bold>Methods:<\/jats:bold> Thirty patients (30 eyes) with AC and twenty normal subjects (20 eyes) were included in this prospective study. All participants underwent a complete ocular examination, including corneal tomography by Pentacam and corneal biomechanics evaluation by Corvis ST. AC patients were evaluated for their eye rubbing frequency and ocular allergic signs.<\/jats:p><jats:p><jats:bold>Results:<\/jats:bold> The elevation at the thinnest location (TE) and the central location (CE), the elevation difference at the thinnest location (TED) and the central location (CED), and the mean value of elevation difference in the central 4 mm zoom (MED) of both the anterior and posterior corneal surface were significantly higher in the AC group than in the normal group (<jats:italic>p<\/jats:italic> &amp;lt; 0.05 for all). In AC patients, only anterior corneal elevation parameters were positively correlated with eye rubbing frequency and ocular allergy sign severity (<jats:italic>p<\/jats:italic> &amp;lt; 0.05 for all), while the tomography and biomechanical index (TBI) was positively correlated with the elevation parameters of both the anterior and posterior corneal surfaces (<jats:italic>p<\/jats:italic> &amp;lt; 0.05 for all).<\/jats:p><jats:p><jats:bold>Conclusion:<\/jats:bold> AC patients carry an increased risk of corneal ectasia. Posterior corneal elevation parameters are sensitive and reliable predictors of keratoconus (KC) risk in AC patients.<\/jats:p><jats:p><jats:bold>Clinical Trial Registration:<\/jats:bold><jats:ext-link>https:\/\/clinicaltrials.gov\/ct2\/show\/NCT04299399<\/jats:ext-link>, identifier [NCT04299399].<\/jats:p>","DOI":"10.3389\/fmed.2021.788302","type":"journal-article","created":{"date-parts":[[2021,11,30]],"date-time":"2021-11-30T16:53:31Z","timestamp":1638291211000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":6,"title":["Changes in Anterior and Posterior Corneal Elevation in Patients With Allergic Conjunctivitis"],"prefix":"10.3389","volume":"8","author":[{"given":"Qian","family":"Wang","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Fei","family":"Yu","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ziqing","family":"Feng","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Weihua","family":"Li","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Naiyang","family":"Li","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Xinyue","family":"Du","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Xuan","family":"Zhao","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Saiqun","family":"Li","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jin","family":"Yuan","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1965","published-online":{"date-parts":[[2021,11,24]]},"reference":[{"key":"B1","doi-asserted-by":"publisher","first-page":"620","DOI":"10.3390\/cells8060620","article-title":"To see or not to see: a systematic review of the importance of human ocular surface cytokine biosignatures in ocular allergy","volume":"8","author":"Aydin","year":"2019","journal-title":"Cells."},{"key":"B2","doi-asserted-by":"publisher","first-page":"1571","DOI":"10.1177\/1120672120942691","article-title":"The prevalence of keratoconus in children with allergic eye disease in an Egyptian population","volume":"31","author":"Ahmed","year":"2020","journal-title":"Eur J Ophthalmol"},{"key":"B3","doi-asserted-by":"publisher","first-page":"697","DOI":"10.1097\/ICO.0000000000002283","article-title":"A case-control study of keratoconus risk factors","volume":"39","author":"Moran","year":"2020","journal-title":"Cornea."},{"key":"B4","doi-asserted-by":"publisher","first-page":"348","DOI":"10.1097\/ICO.0000000000002206","article-title":"Epidemiological association between systemic diseases and keratoconus in a korean population: a 10-year nationwide cohort study","volume":"39","author":"Lee","year":"2020","journal-title":"Cornea."},{"key":"B5","doi-asserted-by":"publisher","first-page":"407","DOI":"10.4103\/0301-4738.116063","article-title":"Ocular allergy and keratoconus","volume":"61","author":"Sharma","year":"2013","journal-title":"Indian J Ophthalmol."},{"key":"B6","doi-asserted-by":"publisher","first-page":"526","DOI":"10.1097\/ACI.0000000000000571","article-title":"Pathogenesis and complications of chronic eye rubbing in ocular allergy","volume":"19","author":"Ben-Eli","year":"2019","journal-title":"Curr Opin Allergy Clin Immunol."},{"key":"B7","doi-asserted-by":"publisher","first-page":"593","DOI":"10.1590\/S0004-27492005000500004","article-title":"Topographic corneal changes in patients with vernal keratoconjunctivitis","volume":"68","author":"Correa Dantas","year":"2005","journal-title":"Arq Bras Oftalmol."},{"key":"B8","doi-asserted-by":"publisher","first-page":"328","DOI":"10.1016\/j.jcrs.2018.10.030","article-title":"Accuracy of scheimpflug-derived corneal biomechanical and tomographic indices for detecting subclinical and mild keratectasia in a South Asian population","volume":"45","author":"Kataria","year":"2019","journal-title":"J Cataract Refract Surg."},{"key":"B9","doi-asserted-by":"publisher","first-page":"664","DOI":"10.3928\/1081597X-20180823-02","article-title":"Differences in posterior corneal features between normal corneas and subclinical keratoconus","volume":"34","author":"Golan","year":"2018","journal-title":"J Refract Surg."},{"key":"B10","doi-asserted-by":"publisher","first-page":"521","DOI":"10.1177\/1120672118760146","article-title":"Comparative evaluation of scheimpflug tomography parameters between thin non-keratoconic, subclinical keratoconic, and mild keratoconic corneas","volume":"28","author":"Huseynli","year":"2018","journal-title":"Eur J Ophthalmol."},{"key":"B11","doi-asserted-by":"publisher","first-page":"976","DOI":"10.1097\/ICO.0b013e31819e34de","article-title":"Evaluation of keratometric, pachymetric, and elevation parameters of keratoconic corneas with pentacam","volume":"28","author":"Mih\u00e1ltz","year":"2009","journal-title":"Cornea."},{"key":"B12","doi-asserted-by":"publisher","first-page":"557","DOI":"10.1016\/j.jcrs.2014.05.052","article-title":"Comparison of multimetric D index with keratometric, pachymetric, and posterior elevation parameters in diagnosing subclinical keratoconus in fellow eyes of asymmetric keratoconus patients","volume":"41","author":"Muftuoglu","year":"2015","journal-title":"J Cataract Refract Surg."},{"key":"B13","doi-asserted-by":"publisher","first-page":"459","DOI":"10.1136\/bjophthalmol-2013-304132","article-title":"Evaluation of corneal elevation, pachymetry and keratometry in keratoconic eyes with respect to the stage of Amsler-Krumeich classification","volume":"98","author":"Kamiya","year":"2014","journal-title":"Br J Ophthalmol."},{"key":"B14","doi-asserted-by":"publisher","first-page":"1534","DOI":"10.1016\/j.ophtha.2008.02.020","article-title":"Sensitivity and specificity of posterior corneal elevation measured by pentacam in discriminating keratoconus\/subclinical keratoconus","volume":"115","author":"de Sanctis","year":"2008","journal-title":"Ophthalmology."},{"key":"B15","doi-asserted-by":"publisher","first-page":"629","DOI":"10.1007\/s10792-020-01618-8","article-title":"Accuracy of the posterior corneal elevation values of pentacam HR from different reference surfaces in early ectasia diagnosis","volume":"41","author":"Elkitkat","year":"2021","journal-title":"Int Ophthalmol."},{"key":"B16","doi-asserted-by":"publisher","first-page":"1348","DOI":"10.1016\/j.jcrs.2013.03.023","article-title":"Posterior corneal elevation and back difference corneal elevation in diagnosing forme fruste keratoconus in the fellow eyes of unilateral keratoconus patients","volume":"39","author":"Muftuoglu","year":"2013","journal-title":"J Cataract Refract Surg."},{"key":"B17","doi-asserted-by":"publisher","first-page":"461","DOI":"10.1016\/j.clae.2015.05.013","article-title":"Topographic corneal changes in children with vernal keratoconjunctivitis: a report from Kathmandu, Nepal","volume":"38","author":"Gautam","year":"2015","journal-title":"Contact Lens Anterior Eye."},{"key":"B18","doi-asserted-by":"publisher","first-page":"555","DOI":"10.1007\/s00417-012-2089-2","article-title":"Corneal biochemical features of patients with vernal keratoconjunctivitis","volume":"251","author":"Emre","year":"2013","journal-title":"Graefe's Arch Clin Exp Ophthalmol."},{"key":"B19","doi-asserted-by":"publisher","first-page":"1","DOI":"10.1186\/s40662-021-00241-7","article-title":"Corneal biomechanical changes in allergic conjunctivitis","volume":"8","author":"Wang","year":"2021","journal-title":"Eye Vis."},{"key":"B20","doi-asserted-by":"publisher","first-page":"250","DOI":"10.1016\/j.ajo.2006.10.027","article-title":"Slit-scanning topography in vernal keratoconjunctivitis","volume":"143","author":"Barreto","year":"2007","journal-title":"Am J Ophthalmol."},{"key":"B21","doi-asserted-by":"publisher","first-page":"712","DOI":"10.1016\/j.ajo.2007.07.021","article-title":"Reproducibility and repeatability of central corneal thickness measurement in keratoconus using the rotating scheimpflug camera and ultrasound pachymetry","volume":"144","author":"de Sanctis","year":"2007","journal-title":"Am J Ophthalmol."},{"key":"B22","doi-asserted-by":"publisher","first-page":"448","DOI":"10.1016\/j.jcrs.2006.11.008","article-title":"Intrasession and intersession repeatability of the pentacam system on posterior corneal assessment in the normal human eye","volume":"33","author":"Chen","year":"2007","journal-title":"J Cataract Refract Surg."},{"key":"B23","doi-asserted-by":"publisher","first-page":"S48","DOI":"10.1097\/ICL.0000000000000432","article-title":"Keratoconus progression in patients with allergy and elevated surface matrix metalloproteinase 9 point-of-care test","volume":"44","author":"Mazzotta","year":"2018","journal-title":"Eye Contact Lens."},{"key":"B24","doi-asserted-by":"publisher","first-page":"370","DOI":"10.3980\/j.issn.2222-3959.2013.03.21","article-title":"Effects of vernal and allergic conjunctivitis on severity of keratoconus","volume":"6","author":"Cingu","year":"2013","journal-title":"Int J Ophthalmol."},{"key":"B25","doi-asserted-by":"publisher","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":"B26","doi-asserted-by":"publisher","first-page":"99","DOI":"10.5336\/ophthal.2018-63355","article-title":"The topographic corneal changes in patients with vernal keratoconjunctivitis","volume":"28","author":"EKINCI","year":"2019","journal-title":"Turkiye Klin J Ophthalmol"},{"key":"B27","doi-asserted-by":"publisher","first-page":"5072781","DOI":"10.1155\/2016\/5072781","article-title":"Expression of TSLP and downstream molecules IL-4, IL-5, and IL-13 on the eye surface of patients with various types of allergic conjunctivitis","volume":"2016","author":"Zheng","year":"2016","journal-title":"J Ophthalmol."},{"key":"B28","doi-asserted-by":"publisher","first-page":"489","DOI":"10.1067\/mai.2002.126379","article-title":"Active matrix metalloproteinases in the tear fluid of individuals with vernal keratoconjunctivitis","volume":"110","author":"Kumagai","year":"2002","journal-title":"J Allergy Clin Immunol."},{"key":"B29","doi-asserted-by":"publisher","first-page":"351","DOI":"10.1080\/02713683.2018.1554150","article-title":"Increased corneal ectasia risk in patients with familial mediterranean fever","volume":"44","author":"Kosekahya","year":"2019","journal-title":"Curr Eye Res."},{"key":"B30","doi-asserted-by":"publisher","first-page":"163","DOI":"10.1016\/j.anai.2012.01.006","article-title":"Allergic conjunctivitis and dry eye syndrome","volume":"108","author":"Hom","year":"2012","journal-title":"Ann Allergy Asthma Immunol."},{"key":"B31","doi-asserted-by":"publisher","first-page":"397","DOI":"10.2500\/ajra.2016.30.4361","article-title":"Dry eye disease and allergic conditions: a Korean nationwide population-based study","volume":"30","author":"Kim","year":"2016","journal-title":"Am J Rhinol Allergy."},{"key":"B32","doi-asserted-by":"publisher","first-page":"49","DOI":"10.3109\/15569527.2015.1010727","article-title":"Evaluation of the tear film instability in children with allergic diseases","volume":"35","author":"Dogru","year":"2016","journal-title":"Cutan Ocul Toxicol."},{"key":"B33","doi-asserted-by":"publisher","first-page":"398","DOI":"10.1097\/ACI.0000000000000471","article-title":"Ocular allergy as a risk factor for dry eye in adults and children","volume":"18","author":"Villani","year":"2018","journal-title":"Curr Opin Allergy Clin Immunol."},{"key":"B34","doi-asserted-by":"publisher","first-page":"777","DOI":"10.1111\/j.1365-2222.2006.02499.x","article-title":"Multiple cytokines in human tear specimens in seasonal and chronic allergic eye disease and in conjunctival fibroblast cultures","volume":"36","author":"Leonardi","year":"2006","journal-title":"Clin Exp Allergy."},{"key":"B35","doi-asserted-by":"publisher","first-page":"103","DOI":"10.1046\/j.1365-2222.2000.00699.x","article-title":"Tear Levels of Interferon-\u03b3, Interleukin (IL)\u22122, IL-4 and IL-5 in Patients With Vernal Keratoconjunctivitis, Atopic Keratoconjunctivitis and Allergic Conjunctivitis","volume":"30","author":"Uchio","year":"2000","journal-title":"Clin Exp Allergy."},{"key":"B36","doi-asserted-by":"publisher","first-page":"710","DOI":"10.1111\/j.1398-9995.2008.01858.x","article-title":"Cytokines, matrix metalloproteases, angiogenic and growth factors in tears of normal subjects and vernal keratoconjunctivitis patients","volume":"64","author":"Leonardi","year":"2009","journal-title":"Allergy Eur J Allergy Clin Immunol."}],"container-title":["Frontiers in Medicine"],"original-title":[],"link":[{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fmed.2021.788302\/full","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2021,11,30]],"date-time":"2021-11-30T16:53:38Z","timestamp":1638291218000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fmed.2021.788302\/full"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2021,11,24]]},"references-count":36,"alternative-id":["10.3389\/fmed.2021.788302"],"URL":"https:\/\/doi.org\/10.3389\/fmed.2021.788302","relation":{},"ISSN":["2296-858X"],"issn-type":[{"value":"2296-858X","type":"electronic"}],"subject":[],"published":{"date-parts":[[2021,11,24]]},"article-number":"788302"}}