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Can biomarkers predict the outcomes of keratoconus

Poster Details

First Author: N.Pahuja INDIA

Co Author(s):    R. Shetty   K. Deshapande   L. Kaweri   C. Sharma   M. Thakkar   A. Ghosh     

Abstract Details


To investigate these biomarkers using gene expression analysis in Keratoconus patient corneal epithelium in order to understand the deregulated pathways that may drive pathophysiology of the disease and correlate it to the clinical outcome after crosslinking.


Narayana Nethralaya Tertiary eye center in South India.


Gene expression analysis for Matrix Metalloproteinase9 (MMP9), interleukin 6 (IL6), Lysyl Oxidase (LOX) and collagen (COLIVA1 and COlIA1) was performed in corneal epithelium from 30 KC subjects undergoing corneal crosslinking using quantitative PCR. These patients were followed up to document the change in mean keratometry (Km), spherical equivalent and corrected distant visual acuity (CDVA) at 1, 3 and 6 month duration. The levels of these biomarkers were correlated with clinical parameters and treatment outcome to evaluate their prognostic potential.


Collagen related genes and collagen crosslinker LOX mRNA levels were significantly reduced in KC patients, which was also confirmed by IHC (Immunohistochemical analysis of Lox and ColIVA1). Clinical outcome at 6 months showed statistically significant improvement in CDVA in patients that correlated with statistically significant, higher levels of LOX and COlIA1. Moreover patients with higher levels of pre-operative COLIVA1 showed significant flattening as reflected by postoperative Km compared to those with lower levels of this basement membrane protein. These data were analysed using a multivariate linear regression model (R2=0.8).


The improved CDVA is possibly related to remodeling of the cornea post surgery causing change in corneal aberrations. Biomarkers can be studied to predict the clinical outcome post surgery. Patients with higher levels LOX and COlIA1 have a significant better CDVA post crosslinking. Additionally COLIVA1, secreted by the basement membrane of corneal epithelium may have a role in predicting the clinical outcome of crosslinking thus of significant prognostic value.

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