Late-onset progression of keratoconus after therapy with selective tissue estrogenic activity regulator

Emilio A Torres-Netto; J Bradley Randleman; Nikki L Hafezi; Farhad Hafezi

doi:10.1016/j.jcrs.2018.08.036

Late-onset progression of keratoconus after therapy with selective tissue estrogenic activity regulator

J Cataract Refract Surg. 2019 Jan;45(1):101-104. doi: 10.1016/j.jcrs.2018.08.036. Epub 2018 Nov 14.

Authors

Emilio A Torres-Netto¹, J Bradley Randleman², Nikki L Hafezi³, Farhad Hafezi⁴

Affiliations

¹ Laboratory for Ocular Cell Biology, Center for Applied Biotechnology and Molecular Medicine, University of Zurich, Switzerland; ELZA Institute, Dietikon, Switzerland; Department of Ophthalmology and Visual Sciences, Paulista School of Medicine, Federal University of São Paulo, São Paulo, Brazil. Electronic address: [email protected].
² USC Roski Eye Institute, University of Southern California, Los Angeles, California, USA.
³ Laboratory for Ocular Cell Biology, Center for Applied Biotechnology and Molecular Medicine, University of Zurich, Switzerland; ELZA Institute, Dietikon, Switzerland.
⁴ Laboratory for Ocular Cell Biology, Center for Applied Biotechnology and Molecular Medicine, University of Zurich, Switzerland; ELZA Institute, Dietikon, Switzerland; Faculty of Medicine, University of Geneva, Geneva, Switzerland; Department of Ophthalmology, University of Wenzhou, Wenzhou, China.

PMID: 30448005
DOI: 10.1016/j.jcrs.2018.08.036

Abstract

We describe the association of rapid progression of keratoconus in a 49-year-old woman on selective tissue estrogenic activity regulator (STEAR) therapy for endometriosis. Approximately 4 months after initiation of therapy with STEAR therapy and 3 months after ovariectomy, Scheimpflug images showed a massive increase in the previously stable ectasia. During this period, the maximum increase in the keratometry values was 2.7 diopters (D) in the right eye and 3.8 D in the left eye. Corneal crosslinking (CXL) was performed in both eyes. This resulted in excessive flattening of 5.5 D in the right eye and 6.1 D in the left eye at 9 months postoperatively. Patients having STEAR therapy must be monitored closely for corneal changes.

Publication types

Case Reports
Research Support, Non-U.S. Gov't

MeSH terms

Collagen / metabolism
Corneal Stroma / metabolism
Corneal Topography
Cross-Linking Reagents
Disease Progression
Endometriosis / drug therapy*
Estrogen Receptor Modulators / adverse effects*
Female
Humans
Keratoconus / chemically induced*
Keratoconus / diagnosis*
Keratoconus / drug therapy
Middle Aged
Norpregnenes / adverse effects*
Ovariectomy
Photosensitizing Agents / therapeutic use
Riboflavin / therapeutic use
Ultraviolet Rays
Visual Acuity

Substances

Cross-Linking Reagents
Estrogen Receptor Modulators
Norpregnenes
Photosensitizing Agents
Collagen
tibolone
Riboflavin