ABSTRACT
Purpose To identify environmental risk factors associated with the need for penetrating keratoplasty (PKP) (full-thickness corneal transplantation) in patients with keratoconus in a Middle Eastern country. Methods This is a retrospective case-control study. This study included patients with keratoconus who underwent PKPor were waitlisted for PKP. Controls were patients diagnosed with keratoconus who did not reach a stage that necessitates PKP. Groups were matched by age and gender. Chi-square test was used to figure out the association between different risk factors including eye rubbing, vernal keratoconjunctivitis (VKC), smoking, paternal consanguinity, eye dryness, family history, asthma, eczema, and diabetes with the need for PKP. Results A total of 111 patients were included in this study, there were 48 (43.26%) men and 63 (56.75%) women. The case group included 42 subjects and the control group included 69 subjects. We found statistically significant differences between the two groups in relation to eye rubbing (p=0.0005), VKC (p=0.005), paternal consanguinity (p=0.02), and smoking rate (p=0.04), all being significant in the group in need of PKP. On the other hand, we did not find out a statistically significant difference between the two groups in relation to family history (p=0.31), dryness (p=0.58), asthma (p=0.15), eczema (p=0.28), or diabetes (p=0.29). Conclusion This study has identified several risk factors associated with the need for PKP in patients with keratoconus, part of which are modifiable. These findings can benefit clinicians in community counseling and give recommendations that can help in preventing or - at least - delaying the need for PKP surgery in keratoconus, such as smoking cessation, aggressive treatment of VKC disease, eye rubbing avoidance, as well as raising awareness regarding the potential risks of paternal consanguinity in this disease entity.
ABSTRACT
Obesity and obesity induced type 2 diabetes development and progression have been associated with sedentary lifestyle. Irisin, a newly discovered myokine, has been demonstrated at lower levels in obese and type 2 diabetes patients compared to controls. The main aim of this study is to explore association of Irisin with diabetic retinopathy (DR). A total of 233 healthy and adults participated in this study. Participants were divided into four categories: a healthy control group and an age-match subset of patients with type 2 diabetes; a positive control group of patients with type 2 diabetes not affected by DR (No DR); and patients with type 2 diabetes affected by DR (non-proliferative DR (NPDR) and proliferative DR (PDR)). Plasma samples were quantified for Irisin measurement, lipid profile and HbA1c. Comparison of the age-matched groups of healthy controls and patients with type 2 diabetes revealed lower Irisin plasma level in type 2 diabetes group. Analyses revealed negative correlations of Irisin to HbA1c and LDL levels and positive correlation to HDL level. Comparing Irisin level in No DR and DR groups revealed a higher level in No DR group and analysis per DR classification indicated higher Irisin level in NPDR group. Our results demonstrate not only correlation of plasma Irisin level with DR stages, but also significantly different Irisin level among them. This is promising in terms of researching Irisin as a potential associating marker for type 2 diabetes and DR development and progression.
