Keratoconus in Eastern Mediterranean Region: Prevalence and risk factors

Abstract

Background: Keratoconus (KC) is common in areas with disease-related risk factors. It is characterised by progressive, non-inflammatory thinning of the cornea with unknown causes and is likely multifactorial.
Aim: To determine the prevalence and risk factors of KC in the Eastern Mediterranean Region (EMR).
Method: The study was conducted according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (2020) guidelines using two sources: electronic databases and reference lists of selected articles. The electronic databases included Web of Science, PubMed, Scopus and Google Scholar. The search period spanned from January 2000 to January 2025. Data were extracted and analysed to determine KC prevalence and associated risk factors using a random-effects model.
Results: In this meta-analysis, 1801 articles were reclaimed, of which 20 were analysed. These 20 articles included 22 000 participants from eight countries in the EMR. The prevalence of KC in EMR was 3.96% (95% confidence interval: 3.75–4.16). The most common risk factors for KC in the region included positive family history in 11 studies, frequent eye rubbing in five studies and consanguinity.
Conclusion: The prevalence of KC in EMR was higher than the global estimate, highlighting significant regional variations between countries. Risk factors, including family history of KC, eye rubbing and consanguinity, were the most important risk factors for KC according to the available evidence.
Contribution: The findings indicate an increase in disease incidence rates and emphasise the necessity for implementing targeted interventions to mitigate the risks associated with the KC in the region.