Risk Factors and Progression of Keratoconus

NCT ID: NCT05676580

Last Updated: 2025-09-05

Study Results

Results pending

The study team has not published outcome measurements, participant flow, or safety data for this trial yet. Check back later for updates.

Basic Information

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Recruitment Status

RECRUITING

Clinical Phase

NA

Total Enrollment

200 participants

Study Classification

INTERVENTIONAL

Study Start Date

2023-06-05

Study Completion Date

2028-05-31

Brief Summary

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Primary objective :

Description of keratoconus at baseline and during progression in 200 participants followed by the ophthalmology departments of CHU Montpellier, CHU Bordeaux and CHU Toulouse during a 2-year period. Clinical outcome, histology of the cornea and tears proteomics will be assessed in 4 groups at different points in time:

* At 6 months in participants with no intervention (risk reduction instructions: not to rub their eyes)
* At 6 months in participants with no intervention that didn't comply with the risk reduction instructions
* At 1 month in participants assigned to cross-linking surgery
* At 1 month in participants assigned to intra corneal ring surgery If both eyes are affected, both will be evaluated with their own visit agenda. Visits for no surgery participants will be set at 6 months, 12 months and 24 months in the absence of intervention (apart from the behavioral risk reduction).

Visits for surgery participants will be set at D7, 1 month, 6 months, 12 months and 24 months after the procedure: cross-linking or placement of the intra corneal ring.

Secondary objective :

Description of the association between clinical outcomes, histological progression of the cornea and tears proteomics in time, 2 years period.

Comparison of tears proteomics in 36 participants with keratoconus followed at CHU of Montpellier and healthy participants at baseline .

Detailed Description

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This trial is a prospective cohort study of 200 participants with keratoconus followed by the ophthalmology departments of CHU Montpellier, CHU Bordeaux and CHU Toulouse during a 2-year period. If both eyes are affected, each will be evaluated considering their own visit agenda. Histological and proteomic evaluations will be performed in 36 participants's eyes whose initial management is abstention of surgery (12 participants), cross-linking (12 participants) or intra corneal ring (12 participants).

The target population consist of participants with clinical keratoconus (topographic Rabinowitz criteria with slit lamp abnormalities and visual impairment), preclinical or crude keratoconus (abnormal or suspicious topography with normal slit lamp examination and normal visual acuity). They will be aged between 10 and 40 years included.

The follow-up will be taken care off by the ophthalmology departments of the Montpellier University Hospital, Bordeaux University Hospital or Toulouse University Hospital Collection of written informed consent, after a period of reflection, will be necessary for adult participants. For minors: informed consent will have to be signed by at least one of the 2 parents or legal guardians, and approval from the child will be asked after a period of reflection. All participants will have to be affiliated to the French social security system or beneficiary of such a system.

Description of the study course:

No therapeutic intervention outside of routine care will be performed. Depending on the therapeutic orientation, the follow-up is carried out as follows:

* Visits at 6 months, 12 months and 24 months in the absence of intervention (apart from the behavioral risk reduction management).
* Visits at day 7, 1 month, 6 months, 12 months and 24 months after the procedure: cross-linking or placement of the intra corneal ring.

In this study, participants will be followed for a maximum of 2.5 years. In addition to the description of keratoconus progression, we will take a tear sample using the Schirmer test to create a biobank. This tears collection will be performed in 36 participants followed at the Montpellier University Hospital, at inclusion and at short-term follow-up visit (6 months if abstention, 1 month if surgery).

Judging criteria:

* Paraclinical examination of the participants
* Ophthalmological paraclinical data
* Confocal microscopy examination
* ABCD classification of keratoconus
* Composition and evolution of tears determined by proteomic analysis
* Survey on risk factors: allergies, atopy, ocular friction, family history, ethnic origin, smoking, dry eye syndrome, low pachymetry

Prevalence of risk factors: a survey will measure the prevalence of risk factors for keratoconus:

* Presence of atopy/allergy
* Eye rubs
* Family history
* Ethnic origin
* Tobacco use
* Dry eye syndrome (survey + clinical examination)
* Low pachymetry

This self-survey will be completed at the inclusion visit and at the last follow-up visit (M24). The time to complete this questionnaire is approximately 10 minutes.

Conditions

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Keratoconus

Study Design

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Allocation Method

NON_RANDOMIZED

Intervention Model

PARALLEL

Primary Study Purpose

HEALTH_SERVICES_RESEARCH

Blinding Strategy

NONE

Study Groups

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Abstention

After keratoconus diagnosis the patient won't be assigned to intervention

Group Type OTHER

abstention

Intervention Type OTHER

No surgery

Intervention (cross-linking surgery or intra corneal ring)

After keratoconus diagnosis the patient was assigned to cross linking surgery or intra corneal ring surgery

Group Type OTHER

cross-linking surgery or intra corneal ring

Intervention Type PROCEDURE

After keratoconus diagnosis the patient was assigned to surgery

Interventions

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cross-linking surgery or intra corneal ring

After keratoconus diagnosis the patient was assigned to surgery

Intervention Type PROCEDURE

abstention

No surgery

Intervention Type OTHER

Eligibility Criteria

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Inclusion Criteria

* Participants with clinical keratoconus (Rabinowitz criteria with topographic slit lamp abnormalities and visual impairment), preclinical or crude keratoconus (abnormal or suspicious topography with normal slit lamp examination and normal visual acuity, visual acuity)
* Followed by the ophthalmology services of the CHU Montpellier, CHU Bordeaux or CHU Toulouse
* For adult Participants: collection of written informed consent, after a period of reflection period
* For minors: informed consent signed by at least one of the 2 parents or legal representatives legal representatives, and assent of the child after a period of reflection
* Affiliation to the French social security system or beneficiary of such a system

Exclusion Criteria

* Person under legal supervision, guardianship or curator
* History of corneal implant on both eyes
* Planned relocation before the end of the first stage of treatment (abstention, cross-linking, intra-corneal ring depending on the participant)
Minimum Eligible Age

10 Years

Maximum Eligible Age

40 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

No

Sponsors

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University Hospital, Montpellier

OTHER

Sponsor Role lead

Responsible Party

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Responsibility Role SPONSOR

Principal Investigators

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Vincent DAIEN, PR

Role: PRINCIPAL_INVESTIGATOR

CHU Monptellier

Locations

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CHU Gui de Chauliac - Service d'Ophtamologie

Montpellier, Occitanie, France

Site Status RECRUITING

Countries

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France

Central Contacts

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Vincent DAIEN, PR

Role: CONTACT

0673055877 ext. +33

Facility Contacts

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Vincent DAIEN, Pr

Role: primary

Other Identifiers

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RECHMPL20_0450 / UF8090

Identifier Type: -

Identifier Source: org_study_id

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