The Distribution of Keratoconus Assessed Using Belin/Ambrósio Parameters According to Age and Gender in a Tertiary Eye Center: A Cross-Sectional Study

Purpose This study compares keratoconus characteristics across different pediatric and adult populations in a tertiary eye center. We used Pentacam HR technology to analyze comprehensive corneal parameters and identify age-related patterns in disease presentation and severity. The findings yield insights capable of informing clinical decision-making and therapeutic strategies for keratoconus management. Methods This cross-sectional retrospective study analyzed 240 eyes from 120 keratoconus patients at a tertiary eye center. The patients were stratified into four age groups: 0-12 years (n=60), 13-18 years (n=60), 19-25 years (n=60), and ≥26 years (n=60). Keratoconus was diagnosed using Pentacam corneal topography, pachymetry, refractive error assessment, and slit-lamp biomicroscopy. Disease staging followed the Amsler-Krumeich classification. Comprehensive corneal parameters were recorded, including anterior and posterior surface measurements (K1, K2, KM, and astigmatism), corneal thickness, corneal volume, anterior chamber depth, and Belin-Ambrósio enhanced ectasia parameters. Results Gender distribution, disease stage, and vision were similar across the age groups. However, significant age-related differences were observed in corneal topography parameters and progression indices. The 0–12 age group exhibited a greater central corneal thickness than the 13–18 and 19–25 age groups, while anterior and posterior curvature measures (K1, K2, and KM) differed significantly among the pediatric and adult groups. Additionally, progression indices including anterior chamber depth, minimum and maximum values, and Ambrósio relational thickness and index of thickness measurements exhibited notable variations, with younger patients generally recording higher values than the older age groups . Males predominantly exhibited Stage I disease (83.3% vs 54.3%, p=0.001) and lower keratometry values (p<0.001), while females displayed more varied disease stages and higher progression indices (D: 8.3±8.6 vs 5.4±3.7, p=0.020; Q-VAL: 0.79±0.44 vs 0.62±0.36, p=0.010), indicating distinct gender-specific patterns in keratoconus manifestation Conclusion The study findings reveal significant age-dependent variations in corneal topography parameters and progression indices among keratoconus patients. The pediatric cohort, particularly those aged 0-12 years, exhibited significantly higher central corneal thickness values and more pronounced alterations in both anterior and posterior corneal curvature measurements than their adult counterparts. Marked elevation was observed in younger patients in several key progression indices, including anterior chamber depth, Ambrosio relational thickness, and index of thickness. These observations suggest a potentially more aggressive disease trajectory in pediatric keratoconus, which may necessitate different clinical approaches. This study underscores the critical importance of early detection through comprehensive screening protocols, age-appropriate prognostic counseling, and individualized treatment strategies tailored to the patient's developmental stage in order to optimize long-term visual outcomes in keratoconus management.