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Incidence and prevalence of keratoconus in Taiwan during 2000–2018 and their association with the use of corneal topography and tomography

Eye volume 38, pages 745–751 (2024)Cite this article

Subjects

Abstract

Purpose

The aim of this study was to determine the age- and sex-specific incidence and prevalence of keratoconus (KC) in Taiwan and explore their association with the use of computerized corneal topography and tomography (TG).

Design

This nationwide retrospective study included the Taiwanese population (N = 27,540,859) from the National Health Insurance Research Database (NHIRD) between 2000 and 2018.

Method

We estimated the incidence of KC by identifying patients with newly diagnosed KC and estimated its prevalence by identifying patients who had the ICD9-CM code 371.6 or ICD-10-CM code H18.609 twice or more in NHIRD during 2000–2018.

Results

The incidence of KC in Taiwan during 2000–2018 was 7075, with the incidence rate being 1.56 (95% confidence interval [CI]: 1.53–1.60) per 100,000 person-years. The prevalence of KC was 4.29 (95% CI: 4.23–4.35) per 100,000 person-years. The KC incidence rate peaked in patients aged 21–25 (6.40 in males and 3.19 in females). The overall incidence rates in males and females were 2.01 and 1.35, respectively (incidence rate ratio: 1.46), indicating that KC had a significant male predisposition. Moreover, we noted a linear correlation (R2 = 0.7488) between the proportion of the use of TG and the incidence of KC.

Conclusion

Estimates of nationwide population-based incidence and prevalence can contribute to a better understanding of the risk of ethnic groups and geographic locations in KC, and the trend can help physicians improve the general vision health of the population.

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Fig. 1: Subjects enrollment.
Fig. 2: The age-specific rate of keratoconus (KC) from 2000–2018, Taiwan.
Fig. 3: The time trend of keratoconus (KC) incidence rate from 2000–2018, Taiwan.
Fig. 4: The time trend of keratoconus (KC) prevalence rate from 2000–2018, Taiwan.
Fig. 5: Correlation between keratoconus (KC) rate and use of corneal topography and tomography (TG) from 2000–2018, Taiwan.

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Data availability

Our data availability is legally restricted. The data we used in this study were owned by a third-party organization, the Health and Welfare Data Science Center (HWDC), an official data center belonging to the Ministry of Health and Welfare. According to government regulation, the data were only available upon request by researchers, not open to the general public. Fellow researchers can apply for the use of the whole database with an ethical permit issued by the institutional review board. The Application Management Review Committee in HWDC will issue access to the national database.

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Author information

Authors and Affiliations

  1. Department of Medicine, School of Medicine, Chang Gung University, Taoyuan, Taiwan

    Jack Min Ng, Ken-Kuo Lin, Jiahn-Shing Lee & Chiun-Ho Hou

  2. Department of Ophthalmology, Chang Gung Memorial Hospital, Linkou Branch, Taoyuan, Taiwan

    Ken-Kuo Lin, Jiahn-Shing Lee & Chiun-Ho Hou

  3. Department of Public Health, College of Medicine, Chang Gung University, Taoyuan, Taiwan

    Wei-Min Chen & Lai-Chu See

  4. Institute of Public Health, School of Medicine, National Yang Ming Chiao Tung University, Taipei, Taiwan

    Chiun-Ho Hou

  5. Department of Ophthalmology, National Taiwan University Hospital, Taipei, Taiwan

    Chiun-Ho Hou

  6. Biostatistics Core Laboratory, Molecular Medicine Research Center, Chang Gung University, Taoyuan, Taiwan

    Lai-Chu See

  7. Division of Rheumatology, Allergy and Immunology, Department of Internal Medicine, Chang Gung Memorial Hospital, Linkou Branch, Taoyuan, Taiwan

    Lai-Chu See

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Contributions

L-CS, CHH and JMN designed the study. L-CS and W-MC performed statistical analyses. CHH, K-KL and J-SL interpreted the findings. JMN, CHH and L-CS, and all co-authors, wrote the manuscript. All authors edited and approved the manuscript.

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Correspondence to Lai-Chu See.

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Ng, J.M., Lin, KK., Lee, JS. et al. Incidence and prevalence of keratoconus in Taiwan during 2000–2018 and their association with the use of corneal topography and tomography. Eye 38, 745–751 (2024). https://doi.org/10.1038/s41433-023-02767-7

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