Evaluation of Central Corneal Thickness in Patients with Vernal Keratoconjunctivitis using Topical Steroids
DOI:
https://doi.org/10.71000/z4cemc31Keywords:
Vernal Keratoconjunctivitis, Central corneal thickness, Steroids, Dexamethasone, PrednisolonAbstract
Purpose: To assess the changes in central corneal thickness (CCT) in patients with VKC using topical steroids.
Methodology: A Qusai-Experimental study was conducted over six months at Sarwar eye care center in Lahore. A total of 34 VKC patients aged 5-25 years were recruited using purposive sampling. Patients underwent baseline evaluation, including history, symptom documentation, and CCT measurement via pachymetry. Topical steroids (e.g, dexamethasone/prednisolone) were prescribed based on disease severity. Follow-up CCT assessments were done at 1 and 3 months. VKC severity and treatment response were monitored throughout. Data were analyzed to assess CCT changes over time.
Results: Among34 vernal keratoconjunctivitis (VKC) patients (mean age: 16.26 years), the most common symptoms were itching with redness (29.4%), both steroids improved VKC severity, with Dexamethasone showing greater improvement (64.7%) compared to prednisolone (36.4%) by the third month. Central corneal thickness (CCT) decreased significantly in both groups; however, Dexamethasone caused a more pronounced thinning (OD:-33.8µm;OS:-30.12µm) then prednisolone (OD: -5.29µm ;OS: -5.99µm). Statistical test confirmed significant CCT changes over time (P<0.001) within and between groups, suggesting better anti-inflammatory efficacy of dexamethasone but a safer corneal profile with prednisolone.
Conclusion: Prednisolone provides safer corneal outcomes with moderate clinical improvement, while dexamethasone is more prosperous in lowering the severity of VKC but results in considerable corneal thinning.
References
Azari AA, Barney NP. Conjunctivitis. JAMA Ophthalmol. 2013;16:1721–9.
Azari AA, Barney NP. Conjunctivitis: a systematic review of diagnosis and treatment. JAMA. 2013;310(16):1721-9.
Simsek C, Kaya C, Karalezli A. Comparison of Central Corneal Thickness Measurements with Four Different New Devices and Ultrasound Pachymetry. Turk J Ophthalmol. 2022;52(5):318-23.
Khaja WA, Grover S, Kelmenson AT, Ferguson LR, Sambhav K, Chalam KV. Comparison of central corneal thickness: ultrasound pachymetry versus slit-lamp optical coherence tomography, specular microscopy, and Orbscan. Clin Ophthalmol. 2015;9:1065-70.
Alexopoulos P, Madu C, Wollstein G, Schuman JS. The Development and Clinical Application of Innovative Optical Ophthalmic Imaging Techniques. Front Med (Lausanne). 2022;9:891369.
Kaur K, Gurnani B. Specular Microscopy. StatPearls. Treasure Island (FL)2025.
Baradaran-Rafii A, Motevasseli T, Yazdizadeh F, Karimian F, Fekri S, Baradaran-Rafii A. Comparison between Two Scheimpflug Anterior Segment Analyzers. J Ophthalmic Vis Res. 2017;12(1):23-9.
Wang SY, Melles R, Lin SC. The impact of central corneal thickness on the risk for glaucoma in a large multiethnic population. J Glaucoma. 2014;23(9):606-12.
Silva FD, M Linhares JM, L, Madalena What intrinsic factors affect the central corneal thickness? Ophthalmic Physiol Opt. 2025;45(1):315-32.
Bruschi G, Ghiglioni DG, Cozzi L, Osnaghi S, Viola F, Marchisio P. Vernal Keratoconjunctivitis: A Systematic Review. Clin Rev Allergy Immunol. 2023;65(2):277-329.
Doan S, Papadopoulos NG, Lee JK, Leonardi S, Manti S, Lau S, et al. Vernal keratoconjunctivitis: Current immunological and clinical evidence and the potential role of omalizumab. World Allergy Organ J. 2023;16(6):100788.
Bremond-Gignac D, Donadieu J, Leonardi A, Pouliquen P, Doan S, Chiambarretta F, et al. Prevalence of vernal keratoconjunctivitis: a rare disease? Br J Ophthalmol. 2008;92(8):1097-102.
Steven B, Shannon B, Katz J. Epidemiology of Vernal Keratoconjunctivitis in the United States: A Claims Data Analysis. nvestigative Ophthalmology & Visual Science 2020;61(7).
Di Zazzo A, Zhu AY, Nischal K, Fung SSM. Vernal keratoconjunctivitis in adults: a narrative review of prevalence, pathogenesis, and management. Front Ophthalmol (Lausanne). 2024;4:1328953.
Leonardi A. Vernal keratoconjunctivitis: pathogenesis and treatment. Prog Retin Eye Res. 2002;21(3):319-39.
Mehta JS, Chen WL, Cheng ACK, Cung LX, Dualan IJ, Kekunnaya R, et al. Diagnosis, Management, and Treatment of Vernal Keratoconjunctivitis in Asia: Recommendations From the Management of Vernal Keratoconjunctivitis in Asia Expert Working Group. Front Med (Lausanne). 2022;9:882240.
Singh R, Boriya A, Bandil Y. To Study the Change in Central Corneal Thickness in Patients with Vernal Kerato-conjuctivitis (VKC) in a Tertiary Health Care Centre (Vindhya Region MP). International Journal of Toxicological and Pharmacological Research. 2024;14(4):72-4
Mohd-Alif WH, Tengku Norina TJ, Shatriah I. Central corneal thickness and topographic indices in Malaysian children with vernal keratoconjunctivitis. Med J Malaysia. 2024;79(4):375-9.
Sen P, Jain S, Mohan A, Shah C, Sen A, Jain E. Pattern of steroid misuse in vernal keratoconjunctivitis resulting in steroid induced glaucoma and visual disability in Indian rural population: An important public health problem in pediatric age group. Indian J Ophthalmol. 2019;67(10):1650-5.
Downloads
Published
Issue
Section
License
Copyright (c) 2026 Ishfaq Ahmad, Ummara Shafiq (Author)
This work is licensed under a Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License.
