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-Vernal keratoconjunctivitis is a condition mediated by Th2 lymphocytes and the precise roles of mast cells, eosinophils, fibroblasts and their cytokines in the inflammatory process and the remodeling of conjunctival tissue remain poorly established. 5
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... In susceptible individuals, the act of rubbing the eyes can cause microtrauma, injuring the epithelium and triggering the release of cytokines, differentiation of myofibroblasts, a shift in biomechanical forces and thinning of corneal tissue. 22,23 Research has demonstrated that rubbing the eyes increases the level of matrix metalloproteinase-13 (MMP) in tears, which plays a crucial role in the apoptotic activity of keratocytes. This leads to a loss of stromal volume as the extracellular matrix is degraded, leading to thinning and ectasia of the cornea. ...
Introduction:
Vernal keratoconjunctivitis (VKC) is a chronic allergic disease characterised by intense ocular surface symptoms and corneal involvement. There is limited data about the corneal changes in children with VKC based on severity of the disease. We aimed to compare the central corneal thickness (CCT) and corneal topographic indices in Malaysian children with VKC, as well as among the varying grades of VKC severity.
Materials and methods:
This study is a comparative, crosssectional and hospital-based study. We recruited 83 children with VKC and 83 healthy children as controls. All children underwent complete ocular examinations, CCT measurement using an ultrasound pachymeter and corneal topography using a Placido disc corneal analyser.
Results:
There was a statistically significant difference of means CCT and topographic indices in children with VKC compared to controls (p<0.05). The probability keratoconus reached 18% in children with VKC. The mean CCT was observed to be thinnest in the severe-to-very severe groups of VKC compared to the mild-to-moderate (p<0.05). The means simulated-K1 and -K2, apical keratometry, apical gradient curvature, superior-inferior index and keratoconus prediction index were significantly different in severe-tovery severe VKC compared to mild-to-moderate VKC and controls (p<0.05). However, there was no significant difference in mean cylinder value and percent probability keratoconus when comparing different groups of severity of VKC (p=0.912 and 0.070 respectively).
Conclusion:
Children with VKC have thinner CCT and topographic indices changes compared to healthy children. Similar pattern was observed between groups with VKC. Degree of astigmatism and probability of keratoconus were similar in mild-to-moderate and severe-to-very severe groups.
