title: The influence of gender and hormone status on the severity and progression of keratoconus.
abstract: OBJECTIVE
  To assess the effects of gender and hormone status on the severity and progression of keratoconus in patients enrolled in the Collaborative Longitudinal Evaluation of Keratoconus Study.
  
  
  METHODS
  The severity and progression of keratoconus in both men (M) and women were evaluated over a 4-year period that encompassed menopausal transition for hormone-active women (HA) and hormone-inactive women (HI). Four outcome measures were selected as indicators of the severity of keratoconus: high-contrast best-corrected visual acuity, low-contrast best-corrected visual acuity, the steep keratometric measurement, and corneal scarring (yes/no).
  
  
  RESULTS
  There were no statistically significant differences among the 3 groups (M, HA, and HI) in race, history of atopic disease, family history of keratoconus, or rigid contact lens wear in the right and left eyes. At baseline, there were no significant differences among the 3 groups in high-contrast best-corrected visual acuity, low-contrast best-corrected visual acuity, or steep keratometric reading. Progression of keratoconus, as assessed by changes in these 3 continuous variables, was equal for the 3 groups. M had more corneal scarring than did HA or HI; however, there was no progression of scarring for any of the groups.
  
  
  CONCLUSIONS
  Keratoconus progressed in both men and women, aged 48-59 years; however, there were no differences among the groups in progression.
authors.affiliation: College of Optometry, The Ohio State University, Columbus, OH 43210-1240, USA.
authors.forename: Barbara A
authors.initials: BA
authors.lastname: Fink
authors.forename: Loraine T
authors.initials: LT
authors.lastname: Sinnott
authors.forename: Heidi
authors.initials: H
authors.lastname: Wagner
authors.forename: Chad
authors.initials: C
authors.lastname: Friedman
authors.forename: Karla
authors.initials: K
authors.lastname: Zadnik
mesh_terms: D018450:Disease Progression; D015914:Estrogen Replacement Therapy; D005260:Female; D006801:Humans; D007044:Hysterectomy; D007640:Keratoconus / Q000503:physiopathology*; D008297:Male; D008875:Middle Aged; D010052:Ovariectomy; D011446:Prospective Studies; D012737:Sex Factors; D011795:Surveys and Questionnaires; D014792:Visual Acuity / Q000502:physiology