Although rare, there are reports of hydrops and the occurrence of spontaneous corneal perforations in PMD. We found that the maximum change in keratometry values was seen at >5 years and between 3 and 5 years follow-up period, supporting that the progression of the condition is over several years. It is observed to be slower than in keratoconus. PMD is known to be a progressive disease, although the rate of progression is not completely known. Keratoplasty (PK – 16 eyes, ALK –8 eyes, crescentic graft – 2 eyes) was needed in 26 eyes. Contact lenses were dispensed in 404 (40.8%) eyes. The majority of the patients were managed with refractive correction with either spectacles or contact lenses. In this cohort of patients, collagen cross-linking was performed in 5.25%. A minor percentage of patients (0.6%) in this study had vernal keratoconjunctivitis confirming that this association is not strong as was also noted in the previous study at our center. The coexisting comorbidities in this study were keratoconus, keratoglobus, and Axenfeld–Rieger anomaly. Mean±SD (range) age in years at presentationĬXL=collagen cross-linking, PK=penetrating keratoplasty, DALK=deep anterior lamellar keratoplasty, ALK=anterior lamellar keratoplasty, VKC=vernal keratoconjunctivitis, NA=not applicable The probable reasons for these could be due to the diagnosis of PMD in the early stages with the improvised diagnostic tools in the more recent years. 44.5%) in comparison with the earlier study. Furthermore, we found a lesser proportion of eyes having astigmatism of >10 D in our cohort (5.56% vs. In this study, the disease was seen in 70.13% of males however, bilaterality was present in 77.1%. An earlier study of 12 years duration between 19, published from the author’s institution showed the male preponderance (77.6%) and bilateral nature (100%) of this disease. The condition is known to be predominantly bilateral, and a male prediction has been reported in some studies. During the same time, the prevalence of keratoconus using electronic medical records diagnosis was found to be 0.62% (31 times commoner than PMD). The overall prevalence of PMD was 0.02% of all eye diseases diagnosed between 20 (~8 years period). The primary purpose of the study was to determine the relative proportion and demographic profile of this relatively rarer ectasia in a clinical care setup. This study sought to describe the clinical profile and demographic distribution of PMD in a large cohort of patients presenting to a multitier hospital network in India using electronic medical records–driven big data analytic. PMD is a rarer form of corneal ectasia when compared with keratoconus, which is far more common. The aim of the authors in this study is to present the clinical profile and frequency distribution of PMD at a large multitier ophthalmology network in India using electronic medical record–driven analytics. There is a paucity of literature on the prevalence and demographic distribution of PMD in the Indian population. According to epidemiological studies about the incidence and prevalence of PMD, it is considered as a rare condition and less common than other ectatic corneal conditions such as keratoconus. The treatment of PMD is mostly conservative with spectacles and contact lens with certain patients requiring surgical intervention like collagen cross-linking or keratoplasty. PMD is a slowly progressive condition that more commonly occurs between the second and fifth decades of life. While the classic presentation of the disease is inferior thinning, there are reports with involvement of the superior, temporal, and nasal parts of the cornea. The corneal protrusion is more marked just superior to the area of thinning where the thickness of the cornea is usually normal. This “beer belly” configuration causes the cornea superior to the ectasia to protrude and produces a flat vertical meridian above the thinning and a high against-the-rule astigmatism. The degree of thinning of the cornea can be severe resulting in up to 80% stromal tissue loss. The corneal area between the thinned band-like region and the limbus is characterized by the absence of lipid deposition, scarring, or vascularization and is typically epithelialized. The term pellucid meaning “clear” to denote the corneal clarity was used for the first time by Schlaeppi. Pellucid marginal corneal degeneration (PMD) is a progressive, noninflammatory ectatic corneal disorder that more commonly involves the inferior cornea separated from the limbus by a relatively uninvolved area of 1 to 2 mm in width.
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