Título

Keratoconus in Systemic Sclerosis: A Cross-Sectional Study ​

Objetivo

The aim of this study was to determine the prevalence of keratoconus and suspect keratoconus in patients with Systemic sclerosis​.

Método

All consecutive adult patients with SSc seen in the Department of Rheumatology of The Clementino Fraga Filho Hospital between 6 months were included.Pregnant women, rigid lens wearers, and patients with a history of refractive surgery were excluded.​All included patients underwent Dual- Scheimpflug camera (Galilei) to detect keratoconus or suspect keratoconus.​Diagnosis of keratoconus and suspect keratoconus were based on clinical judgment of refractive surgeon specialist (MRS)​

Resultado

Twenty patients with SSc were included. Mean age was 53.2 years being 19 were women and just 1 man. Mean disease duration was 12.6 years.​ Overall prevalence of keratoconus and suspect keratoconus was 25% (95% confidence interval [CI] 11 % to 47%). Two (10%) patient had diagnosis of keratoconus.The image bellow shows anterior axial curvature maps and Best-fit Toric and Aspheric surface (BFTA) maps of the cornea of the two patients with systemic sclerosis and keratoconus, obtained by Ziemer Galilei dual Scheimpflug system.​1A and 1B represent the anterior curvature map of the right and left eye, respectively, of patient 1. 2A and 2 B represent the anterior curvature map of the right and left eye of patient 2. 1C and 1D represent the right and left BFTA of patient 1 and 2 C and 2 D represent the right and left BFTA of patient 2. In both patients there are asymmetry between eyes, inferior steepening and posterior elevation, consistent with Keratoconus diagosis.

Conclusão

The high prevalence of keratoconus and keratoconus suspects observed in patients with systemic sclerosis warrants further studies and suggests that the corneal biomechanical properties might be affected by the disease. ​