Alterations in Corneal Sensitivity, Staining and Biomechanics of Alopecia Areata Patients
A recent study examined corneal sensitivity, staining, and biomechanics in patients with severe alopecia areata. This was published in the Journal of Clinical Medicine in 2024.
Alopecia areata, an autoimmune disorder known for causing hair loss, has shown associations with various eye-related health issues. However, the relationship between alopecia areata and specific corneal changes has not been thoroughly investigated until now.
Burgos-Blasco B et al. 2024
The researchers conducted a case-control study to investigate the connection between alopecia areata and certain changes in the cornea. They enrolled 25 patients suffering from severe alopecia areata, defined as having over 50% scalp involvement according to the Severity of Alopecia Tool. These patients were compared to 29 control participants who did not have the condition. All participants were adults over 18 years old and had not undergone any recent systemic treatment for alopecia areata.
The study involved a comprehensive series of ophthalmological evaluations. These evaluations included assessing visual acuity, measuring corneal sensitivity using the Cochet–Bonnet esthesiometer, and conducting slit-lamp biomicroscopy. Furthermore, corneal topography was analyzed with Pentacam, and corneal biomechanics were examined using Corvis scheimpflug technology. The study focused on various outcomes, including visual acuity, refractive error, corneal aerometry, and biomechanical factors such as applanation lengths, velocities, and the Corvis Biomechanical Index, along with topographic measurements.
What were the results?
Patients suffering from alopecia areata demonstrated a significant decrease in corneal sensitivity compared to the control group, with a p-value of less than 0.001. Additionally, these patients experienced increased corneal staining (p = 0.004), which was notably associated with more advanced cataracts, also showing a p-value below 0.001.
When examining corneal topography, measurements such as the anterior topographic flat meridian, average anterior keratometry, and the maximum keratometric point were all found to be higher in the alopecia areata group (p ≤ 0.040).
In contrast, the pachymetry readings indicated thinner corneas in these patients (p ≤ 0.001). From a biomechanical standpoint, significant alterations were observed as well. Patients with alopecia areata had shorter applanation lengths (p ≤ 0.029) and a higher Corvis Biomechanical Index (p = 0.022). Worryingly, within this group, two individuals were diagnosed with keratoconus, and four other eyes exhibited signs of subclinical keratoconus.
Conclusions
This research highlights notable changes in corneal sensitivity, increased staining, and significant shifts in corneal biomechanics and topography in patients with severe alopecia areata. These results indicate that those with alopecia areata might have a higher risk of developing keratoconus. It’s important to consider whether eye doctors should be performing more regular checks for eye-related issues in these patients.
To summarize, this emphasizes the need for consider detailed eye exams in patients with alopecia areata, particularly in severe cases. Spotting potential eye problems like keratoconus early on can lead to timely treatments and improved outcomes for patients.
REFERENCE
Burgos-Blasco B et al. Alterations in Corneal Sensitivity, Staining and Biomechanics of Alopecia Areata Patients: Novel Findings in a Case-Control Study. J Clin Med . 2024 Apr 21;13(8):2426. doi: 10.3390/jcm13082426.