Transcript CERA PowerPoint Presentation - Centre for Eye Research Australia

The latest from the Australian Study of
Keratoconus
Dr Srujana Sahebjada
Postdoctoral Research Fellow/Optometrist
Ocular Genetics Unit
Keratoconus

30% of corneal grafts in Australia

At
least
10,000
patients
Keratoconus(KC) in Victoria alone

Affects the prime working and child-rearing
years of life
Side view of Normal cornea (top) and keratoconus (bottom) showing
anterior protrusion of the cornea.
with
Signs & Symptoms
Corneal Thinning
Fleischer’s ring
Vogt’s striae
Corneal Hydrops
Munson’s
Sign
Aetiology
Eye rubbing
 Allergy
Genetic influence
 Twin studies
 Connective tissue
dysfunction
 Familial aggregation studies
Contact lens wear
 Genetic analyses
Familial disposition
Australian Study of Keratoconus
ASK is a well characterized study on a large
population of Keratoconus subjects aimed to better
understand the risk factors, clinical characteristics and
genetic aspects of KC.
Patient recruitment

Stage 1- Obtaining the patient consent.

Stage 2- Completing the questionnaires.
https://redcap.cera.unimelb.edu.au/redcap/

Stage 3- Eye examination.

Stage 4- Blood sample or saliva sample collection for genetic
analysis.
Demographics
Gender
195 (59.1%) –Males
135 (40.9%)-Females
330
Family
History
43 (13.0%) –Familial
287 (87%)-Sporadic
Distribution of
ethnicity
Number of Keratoconus individuals
Age distribution
160
Mean 35.5 + 14.8 years
Range 11-78 years
140
120
ASIANS
14.6%
100
80
OTHERS
17.2%
60
40
20
6%
0
1-17
55%
18-35
25%
36-53
Age Group (Years)
14%
54+
EUROPEANS
68.2%
KC Research innovations at CERA
1)
Economic impact of Keratoconus - a patient’s perspective
2)
Genome wide expression profiling of keratoconus & non
keratoconus corneas
3)
Early detection of keratoconus using advanced image &
genetic techniques in families of keratoconus subjects
4)
Keratoconus
Blindness)
Cross
Linking
Registry
(Fight
Corneal
PUBLICATIONS

Assessment of Macular Parameter Changes in Patients with Keratoconus Using Optical Coherence Tomography.
Sahebjada S et al. J Ophthalmol. 2015

Impact of keratoconus in the better eye and worse eye on vision-related quality of life through the vision specific
multi assessment utility index - the Vision and Quality of Life Index. Sahebjada S et al. Invest Ophthalmol Vis
Sci.2014

Association of the Hepatocyte Growth Factor gene with Keratoconus in an Australian Population. Sahebjada S et
al. PLoS One. 2014.

Assessment of anterior segment parameters and clinical correlation of corneal curvature in Keratoconic eyes.
Sahebjada S et al. Optometry and Vision Science 2014.

Evaluating the association between keratoconus and the corneal thickness genes in an independent Australian
Population. Sahebjada S et al. Invest Ophthalmol Vis Sci. 2013.
CONFERENCES
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
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
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
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UoM Dept of Surgery Research Day, Australia. 2015
Asia Cornea Society, Taiwan.2014
Eucornea Conference, Europe. 2013
Association for Research in Vision and Ophthalmology annual Meeting, US. 2012
Royal Australian and New Zealand and College of Ophthalmologist, Australia. 2012
Biomed conference, Australia. 2012
Melbourne Ophthalmic Alumni Meeting, Australia.2011
Economic burden of Keratoconus
 Represents a significant public health concern.
 Most KC patients incur high out-of-pocket expenses as a result of
Direct costs - glasses, contact lenses, contact lens solutions, pharmaceuticals,
hospitals, health practitioners
&
Indirect costs -informal care and support and time taken off from work
 The results from this study will directly reflect the patient's perspective.
Gene expression analysis of keratoconus & non
keratoconus corneas
 Corneal buttons are typically
discarded following corneal
transplantation.
 This work will allow us to
identify high risk individuals
who are yet to develop
Keratoconus.
 Long-term aim is to stopping its
progression to more advanced
stages of the disease.
Early detection of Keratoconus

Recent
advances
in
imaging
techniques allows the early detection
of corneal changes.

Clinical examination of family
members may reveal the potential
predisposing features/ subclinical
keratoconus.

Thus the collection of family
members will enable us to assess the
underlying risk factors.
Keratoconus Cross Linking
(Fight Corneal Blindness)
Registry
 To record the use of CXL treatments and to assess the results and safety
of different treatment regimens
 Minimum demographics such as age, gender, post code
 Corneal measurements before and after treatment
 CXL treatment tracked against impact on vision over time
SIGNIFICANCE OF THE PROJECTS

Estimating the economic burden of keratoconus will be the world's first and
largest study.

Advanced imaging techniques can assist in detecting subclinical keratoconus.

Cross linking registry will help develop guidelines for eye doctors to provide the
best management for their patients with keratoconus.

Ultimately this may allow the majority of keratoconus patients to be managed
with glasses or contact lenses.
Volunteers with Keratoconus and their family members are invited to participate.
For more information or for an appointment you can contact:
Dr Srujana Sahebjada
E-mail: [email protected]
Mobile: 040 4181 677