Computerized corneal topography in a paediatric population with Down syndrome

Purpose: To characterize abnormal corneal topographic changes using corneal computerized videokeratography (CVK) in a paediatric population with Down syndrome, and in their parents. Methods: Prospective, non-randomized clinical trial. Twenty-one children with Down syndrome (mean age 6.9 years) recruited from The Hospital for Sick Children, 18 of their parents, and a paediatric control group of 60 otherwise well children (mean age 9 years), underwent complete ocular examination and CVK using the EyeSys system. Corneal topographic maps were assessed subjectively, and three objective parameters analysed: central corneal power (CP), difference in central corneal power between the two eyes (DCP), and inferior-superior steepening asymmetry (I-S). Results: Corneal curvature in children with Down syndrome was significantly steeper than in the paediatric control population (CP 46.66 vs 42.60 D, P < 0.0001), but changes with age paralleled that of the control population. DCP and I-S values were also significantly different from the control population (P < 0.0001). 39% of the parents of children with Down syndrome had at least one abnormal parameter. Conclusions: This study demonstrates that CVK is a useful tool in the ocular assessment of patients with Down syndrome. The findings suggest that this patient population have abnormalities of corneal shape even in the absence of clinical evidence of keratoconus. A greater than expected incidence of abnormal topographic changes was observed in the parents of these patients.