To what extent is pregnancy-induced keratoconus progression reversible? A case-report and literature review

Abstract

Purpose: This report aims to present a case with pregnancy-induced keratoconus (KC) progression and recovery in topographical parameters after a period from delivery/breastfeeding. Methods: A 29-year-old woman with bilateral KC experienced progression in maximum keratometry (Kmax; from 47.6 to 48.2 D in the OD and from 53.7 to 55.2 D in the OS) and several Pentacam indices in both eyes. Results: The Belin ABCD progression score remained unchanged in the right eye (A0B2C0D0) but increased in the left eye (from A2B3C1D1 to A2B4C1D1) (Pentacam HR, Oculus Optikgerate GmbH, Wetzlar, Germany) during pregnancy/breastfeeding. About 6-months after cessation of breastfeeding, Kmax improved to baseline values in both eyes. Although there were improvements in A and B scores, final ABCD stage remained higher than the baseline value in the left eye. Conclusions: The current report shows asymmetrically bilateral progression of KC during pregnancy and early post-delivery period, which was followed by a partial recovery in Pentacam parameters after discontinuation of breastfeeding. These findings seem to confirm the postulated link between pregnancy and KC progression. On the other hand, in patients with KC, pregnancy-induced corneal alterations might recover after delivery/breastfeeding and clinician should wait for stabilization of corneal parameters to determine treatment strategy.