{"doi":"10.1016/j.xops.2023.100364","title":"Prospective Observational Study Evaluating Systemic Hormones and Corneal Crosslinking Effects in Keratoconus","abstract":"PurposeTo evaluate associations between hormone levels in patients with keratoconus (KC) and corneal parameters before-and-after photooxidative corneal collagen crosslinking (CXL).DesignProspective, observational cohort study.Participants28 patients with KC who were scheduled for CXL at an Aarhus University Hospital in Denmark.MethodsAndrogen (dehydroepiandrosterone sulfate, DHEA-S) and estrogen (estrone and estriol) plasma levels were measured and clinical assessments were performed before CXL and 2 – 3 months post-CXL comparing the CXL-eye with the control eye from the same participant.Main Outcome MeasuresAssociations between hormone levels and maximum corneal curvature (Kmax) and minimum central corneal thickness (CCtmin) before-and-after CXL.ResultsCXL was associated with a 2% reduction in Kmax values in the CXL-eye post-CXL from baseline (median = 56.8 D, 95% CI [50.4 – 60.3]) to the second visit (55.7 D, 95% CI [50.4 – 58.8], p = 0.0005). Systemic DHEA-S levels were 5 – 6 orders of magnitude higher than estriol or estrone concentrations in plasma. Importantly, estriol levels, rather than DHEA-S or estrone levels, were more closely correlated with Kmax before CXL (Spearman r = 0.55, p = 0.01). Post-CXL Kmax and CCtmin was not associated with DHEA-S, estrone or estriol plasma levels at the same timepoint.ConclusionsThis study provides supporting evidence based on a KC clinical population that systemic estrogen levels may influence corneal parameters (curvature and thickness) pre-CXL. Further studies evaluating the interplay between the therapeutic benefits of CXL and systemic hormone distributions are needed to determine if perturbation of the local corneal microenvironment influences endocrine function.","journal":"Ophthalmology Science","year":2023,"id":351390,"datarank":0.0,"base_score":0.0,"endowment":0.0,"self_citation_contribution":0.0,"citation_network_contribution":0.0,"self_endowment_contribution":0.0,"citer_contribution":0.0,"corpus_percentile":null,"corpus_rank":null,"citation_count":9,"citer_count":0,"citers_with_citation_signal":0,"citers_with_endowment":0,"datacite_reuse_total":0,"is_dataset":false,"is_dataset_confidence":0.9345,"is_data_producer":false,"deposit_databanks":null,"is_oa":true,"file_count":0,"downloads":0,"has_version_chain":false,"published_date":"2023-01-01","fair_score":null,"fair_percentile":null,"algorithm_id":"datarank_citation_only_1hop_v6","ranking_scope":"data_only","authors":[{"id":1096078,"name":"Sashia Bennett","orcid":"0000-0001-5323-9072","position":1,"is_corresponding":false},{"id":259048,"name":"Sarah E. Nicholas","orcid":"0000-0003-1738-4066","position":2,"is_corresponding":false},{"id":409375,"name":"Jesper Hjortdal","orcid":"0000-0002-1309-8006","position":3,"is_corresponding":false},{"id":325266,"name":"Tina B. McKay","orcid":"0000-0003-0130-9272","position":4,"is_corresponding":false},{"id":259050,"name":"Dimitrios Karamichos","orcid":"0000-0002-8761-3824","position":5,"is_corresponding":false},{"id":670101,"name":"Lyly Van","orcid":null,"position":0,"is_corresponding":true}],"reference_count":52,"raw_metadata":null,"created_at":"2026-07-19T01:12:41.740237Z","pmid":"37868794","pmcid":null,"fwci":null,"citation_percentile":null,"influential_citations":0,"oa_status":null,"license":null,"views":0,"total_file_size_bytes":0,"version_count":0,"fair_f":null,"fair_a":null,"fair_i":null,"fair_r":null,"fair_zscore":null,"fair_rationale":null,"fair_model":null,"fair_agent_version":null,"fair_fulltext_source":null,"fair_has_llm":null,"fair_computed_at":null,"clinical_trials":[],"software_tools":[],"db_accessions":[],"linked_datasets":[],"topics":[]}