While its etiology is not yet fully understood, psoriasis—a chronic, hyperproliferative, inflammatory skin disease that shortens the life cycle of skin cells—can present with eye problems such as eyelid and eyelash problems, peripheral corneal thinning and even permanent vision damage if left untreated. A new study now suggests keratoconus may be on the list of ocular manifestations.

Researchers recently found that the more severe the psoriasis, the greater the topography map changes, and the association persists both in the beginning stages of the disease and the longer it lasts, indicating a potential relationship between the two conditions.

The study evaluated 110 eyes of 55 psoriasis patients and 110 eyes of 55 age- and sex-matched healthy volunteers. All participants underwent a detailed dermatological and ophthalmological examination, and the researchers compared pachymetric, aberrometric and topometric values between the two groups.

Although the average Kmax value and Belin/Ambrósio enhanced ectasia total deviation value were similar between the two groups, the team notes that the mean index of vertical asymmetry value was significantly higher in the psoriasis patients (0.14mm) than in controls (0.11mm). They discovered that 26 eyes of 16 patients with psoriasis were KC suspects, and another two eyes already had a diagnosis of KC. They add that there was a positive correlation among topometric parameters, especially between disease duration and psoriasis severity, and a negative correlation among topometric parameters and the beginning stages of psoriasis.

“Although these results do not necessarily mean that patients with psoriasis will definitely experience KC at some point in their lives, they strengthen the suspicion that there may be a relationship between psoriasis and KC,” the study authors concluded. “In our opinion, it would be useful to conduct regular eye examinations more often for these patients.” 

Akcam HT, Karagun E, Iritas I, et al. Keratoconus could be associated with psoriasis: novel findings from a comparative study. Cornea. September 30, 2019. [Epub ahead of print].