Improving outcomes for people with keratoconus
Mr Stephen Tuft | GR001147
6 November 2020
Early diagnosis is an important factor for the outcome of treatment options in many diseases. This is true for many patients with keratoconus where the condition can progress to cause poor vision.
We are funding a PhD studentship which aims to improve diagnosis and outcomes of keratoconus through the analysis of integrated clinical, imaging and genetic data.
Keratoconus is a common eye condition and is prevalent amongst young adults. The cornea is the clear front part of the eye. It focuses light on the retina, at the back of the eye and, helps us to see clearly. However, in patients with keratoconus, the cornea becomes thinner and weaker over time which can lead to poor and blurred vision.
What is keratoconus
Keratoconus is a non-inflammatory eye condition. It causes the cornea, a round dome-shaped clear window of the eye, to progressively thin forming a cone-like bulge. This eventually impairs the ability of the eye to focus properly, potentially causing poor vision.
- It is usually diagnosed in young people in their late teens or early twenties
- The exact cause remains unknown but genetics and environment factors are believed to play a role
- It is more common in non-caucasians
- At early stages of the condition, glasses or contact lenses may be used to correct vision
- In very advanced cases a corneal transplant may be needed
If untreated, keratoconus can progress to loss of vision and is the leading cause of sight loss in young adults globally. One current treatment is cornea cross-linking, which includes using UV light to strengthen the corneal tissue. It is the only treatment available which has been shown to slow or pause the progression of the disease. Early detection is needed however to ensure the condition is managed and treatment options are viable. But diagnosing the disease early is challenging.
It is the aim of this PhD studentship to investigate the possibilities of innovative and integrated approaches to identify and pre-emptively treat keratoconus. And they will use advances in imaging, genetics and artificial intelligence to tackle this.
Finding a solution
Professors Stephen Tuft and Alison Hardcastle with Dr Nikolas Pontikos and colleagues have established the Moorfields Corneal Bioresource. This is a large database combining longitudinal imaging data linked to clinical notes and genetic data from over 3000 patients who have attended refractive and keratoconus clinics.
The PhD student working on this project will develop algorithms to help detect keratoconus early. They will use these algorithms to provide personalised grading of risk for progression and treatment. The effects of environmental and genetic factors on progression of keratoconus will also be explored. This includes ethnicity, age, smoking status and deprivation index which may affect the deterioration of vision.
The early detection for personalised treatment of keratoconus is integral to maintaining healthy vision. It is important to prevent the progression of keratoconus to a stage where more invasive procedures, such as corneal transplantation, are required. A better understanding of the genetic and environmental factors leading to corneal deterioration could enable the development of potential novel therapies to treat keratoconus early.
Mr Stephen Tuft
Corneal/ocular surface disease | Genetics/inherited eye disorders