Topographic Patterns and Demographic Profile of Keratoconus in the Qassim Province of Saudi Arabia: A Retrospective Analysis.

Abstract

Background: While the Middle East is recognized as a high-prevalence region for keratoconus (KC), significant local variations exist, and there is a notable lack of epidemiological data from the Qassim province of Saudi Arabia. This study aimed to characterize the demographic and topographic patterns of KC in this previously unstudied population.

Methods: A retrospective, cross-sectional study was conducted on the records of 62 patients diagnosed with KC at different hospitals in the Qassim province between January 2020 and March 2023. Demographic data and corneal topographic parameters from Scheimpflug imaging were extracted. Non-parametric tests (Mann-Whitney U, Kruskal-Wallis H) and Spearman's correlation were used for statistical analysis.

Results: The cohort demonstrated a male predominance (62.9%, n=39), with the largest proportion of patients (48.4%, n=30) in the 26-35 year age group. The most prevalent morphological pattern was an inferiorly located cone, observed in 67.7% of right eyes and 80.6% of left eyes. A statistically significant difference in maximum keratometry (Max K) was found across age groups in the left eye (p=0.043), specifically between the 26-35 and 46-55 age groups (p=0.047). Cone location was also significantly associated with disease severity (p<0.05). A strong, statistically significant inverse correlation was confirmed between Max K and thinnest corneal pachymetry in both right (rs​ = -0.754, p < 0.001) and left eyes (rs​ = -0.676, p < 0.001).

Conclusion: This study provides the first clinical and topographic profile of keratoconus in the Qassim province, revealing a pattern of male predominance and a typical diagnosis in the third decade of life, which may suggest a delay in detection. The findings establish an essential evidence-based baseline for regional clinical management and underscore the need for public health initiatives aimed at earlier diagnosis.