Corneal biomechanics alterations and increased risk for corneal ectasia in Turner syndrome

Purpose: To assess corneal tomographic parameters and biomechanics of patients with Turner syndrome. Methods: Thirty-four eyes of 17 patients with Turner Syndrome (TS) and 20 eyes of 10 healthy females were evaluated for corneal parameters and biomechanics. The main outcome measures were anterior and posterior keratometry (K-meanAnt and K-meanPost) anterior and posterior elevation (AE, PE), central corneal thickness (CCT), anterior and posterior Q values (QAnt and QPost), corneal volume (CV), Belin-Ambrosio Tomographic Index (BAD), and biomechanical parameters such as Corneal Biomechanical Index (CBI), and Tomography-Biomechanical Index (TBI). The group of patients with TS was compared to a control group for all evaluated parameters. Results: Significantly higher values of PE, CCT, CV, BAD, and TBI were observed in Turner Syndrome. The TS group displayed significantly lower K-meanPost, QAnt, and QPost values. BAD, CBI, and TBI values exceeding the cut off were observed in nine eyes (26.47%) in the TS group and three eyes (15%) in the control group. Patients with TS showed altered BAD values (odds ratio of 4.88). The TBI index was altered, with an odds ratio of 7.33, suggestive for significantly higher risk of ectasia. The CBI index was unvaried between groups. The cases with pathological BAD value were observed in individuals with mosaicism, suggesting a potential link between this karyotype and BAD alterations. Conclusions: Patients with TS exhibit altered biomechanical values indicating a significant risk for corneal ectasia. Periodic monitoring of corneal parameters in this population is necessary to detect early signs of ectasia.