Secondary Lipid Keratopathy Clinical and Demographic Factors Identified

Secondary lipid keratopathy most commonly affects men aged between 50 and 60 years and results in mild or no visual impairment, according to a study published in Contact Lens & Anterior Eye. Non herpes simplex virus (HSV) corneal scars were the most common associated condition, the report shows.

Investigators reviewed electronic health record data from 3,082,727 patients presenting to a multi-tier hospital system in the cross-sectional analysis and diagnosed lipid keratopathy according to clinical slit lamp findings, which included yellowish-white opacification of corneal stroma associated with accompanying blood vessels. A Chi square test was used for univariate analysis to detect significant differences in demographic features between patients with lipid keratopathy and the overall population. Among the individuals included in the assessment, 389 patients (53.5% men, mean age, 47.2  years) were diagnosed with secondary lipid keratopathy with a unilateral affliction (82.8%).

Patients with secondary lipid keratopathy most frequently presented for treatment between the ages of 50 and 60 years (19.5%), tended to be of lower to lower-middle socioeconomic status (93.6%), live in rural environments (49.1%), and work in a profession involving agriculture or manual labor (23.9%).

Mild or no visual impairment (20/70 or better) was noted in 194 (42.5%) eyes, followed by moderate visual impairment (20/70 to 20/200) in 81 (17.8%) eyes. The mean visual acuity was 0.96 logarithm of the minimum angle of resolution (logMAR) at baseline. 

The most common associated corneal conditions were non HSV corneal scar (36.8%), spheroidal degeneration (19.7%), and HSV keratitis (18.6%), according to the report. HSV keratitis was most common among participants aged 20 to 40 years.

“Secondary lipid keratopathy occurs due to deposition of lipids into a neovascularized area of the cornea; and hence, any cause of corneal scarring with neovascularization can lead to lipid keratopathy,” according to the researchers. “The common etiologies of corneal scarring with neovascularization are categorized into inflammatory, traumatic, iatrogenic, and degenerative. Analyzing the concomitant and/or primary corneal conditions associated with lipid keratopathy indicates the pattern of common corneal diseases seen in the cohort of population under study.”

Study limitations include possible deviations in the uniform criteria of diagnosing lipid keratopathy and the inability to characterize by area, region, or quadrant of corneal involvement.