الفهرس 
CorneaOnly 14 pages are availabe for public view
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Abstract
Vernal keratoconjunctivitis is known to be one of the most severe forms of ocular allergy with potential to cause corneal damage and permanent visual loss. Corneal involvement in VKC patients occurs in the form of superficial punctate keratitis, with superficial pannus, pseudogerontoxon, shield ulcer, astigmatism and keratoconus. Children with VKC have a high incidence of keratoconus and astigmatism and have more abnormal corneal topography patterns compared with normal eyes.
VKC is an important cause of hospital referral among children in many parts of Africa, Asia, and the Middle East with a prevalence of 5% reported for children in their first decade in Chad and Djibouti. The pathogenesis of VKC is complex and involves environmental, endocrine, racial, and genetic factors.
Recent epidemiological reports provide evidence of a genetic component to the disease. Studies of patients living in regions where the disease is rare (such as Europe) show that most VKC sufferers are first generation or second-generation immigrants from areas where the disease is endemic. Menoufia Governorate is primarily an agricultural and rural area in the Egyptian Delta. This dusty and pollen loaded environment increases the potential of allergic diseases including VKC especially in young age group. However, the magnitude of VKC is not well known among young people. Therefore, this work was conducted to determine corneal topographic characteristics of children with vernal keratoconjunctivitis (VKC) and compare the corneal topographic indices in VKC subjects with normal subjects.
A cross sectional study was conducted on children with vernal keratoconjunctivitis attended outpatient clinic of Menoufia University Hospital, Faculty of medicine, Menoufia University in the period from March 2018 to March 2019.
All study patients were divided in two groups:
group I: included 30 eyes of Children with vernal keratoconjunctivitis aged between (7-18) years.
group II: include 30 eyes of normal subject’s age and sex matched.
Inclusion criteria:
- Children suffering from keratoconjunctivitis aged between (7-18) years
- Children suffering severe itching, photophobia, foreign body sensation, mucous discharge blepharospasm, and blurring of vision
Exclusion criteria:
- Children with other ocular or systemic disease
- High myope children more than 6 diopters.
- Children have ptosis or squint.
- Children with history of previous ocular surgeries.
All cases were subjected to the following:
A. History taking:
Summary
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B. Examination data:
- Uncorrected visual acuity (UCVA) and best corrected visual acuity (BCVA).
- Slit lamp bio microscopy.
- Intra-ocular tension by Goldmann applanation tonometry.
- Fundus examination by slit lamp with +90D Volk lens:
C. Investigation:
— Corneal topography:
— General medical investigations
— Pentacam imaging
Results of the current study could be summarized as follow:
Mean age of patients was 13.13±2.92 years and 14.67±2.97 years for healthy children. Also, 53.33% of VKC children were males and 46.77% were males.
There were no statistically significant differences between children with vernal keratoconjunctivitis (VKC) and normal groups regarding side (p=0.795),
Children n with VKC group had significantly increased of K1, K2 and K max, Keratoconus index, index of surface variance and index of vertical asymmetry than normal group
Children with vernal keratoconjunctivitis (VKC) had significantly decreased of thinnest location (529.43±34.72) than normal groups (569.30±16.43) with (p<0.001).
Type of spring chataharal was significantly different among VKC patients‟ groups (p=0.004). Mixed type was the most common among 18 cases (60%), followed Limbal type by 9 cases (30%). While, Palpebral type was the lowest presented among children with vernal keratoconjunctivitis by 3 cases (10%)
There was a large AUC for K1 (0.772). However, the AUC was the greatest for the multimeric CCT (0.870), followed by K2 (0.867) and K max (0.816), with highly significant differences (p<0.001). While, IVA, ISV and KI cutoff value of 0.11, 25.5 and 0.563 respectively.