Determination of serum homocysteine, folic acid, Vitamin D3, and thyroid profile in keratoconus patients

Abstract Purpose: The aim of the study is to determine the serum homocysteine, folic levels, Vitamin D3, and thyroid profile in keratoconus (KC) patients. Designs: The design involves hospital-based, prospective, cross-sectional study. Methods: This study included all patients diagnosed with KC between July and October 2024 in our tertiary care center in Karnataka, India, above 12 years of age, inclusive of both genders who/whose guardians were willing to give informed consent. Data were entered in an Excel spreadsheet, and SPSS version 20 was used to perform the statistical analysis. Results: The average age of the subjects was 18.58 ± 5.05 years. The largest age group was 16–20 years, comprising 40.0% of the subjects ( n = 45). Females represented 57.8% ( n = 26), while males formed 42.2% ( n = 45) of the total sample. The means of the parameters were as follows: uncorrected distance visual acuity (UCVA) (0.81 ± 0.42), Avg SimK (53.23 ± 6.08) and Kmax (62.78 ± 8.48). There was no statistically significant correlation of serum homocysteine and folic acid levels with the following parameters: UCVA ( P = 0.516; P = 0.618), Avg SimK ( P = 0.817; P = 0.734), CCT ( P = 0.383; P = 0.326), and KC Severity Index (KISA) index ( P = 0.523; P = 0.662). Free thyroxine showed a negative association with Avg SimK ( P = 0.033) and KISA Index ( P = 0.008), while TSH showed a positive association with CCT ( P = 0.042). Conclusion: High serum homocysteine and low serum Vitamin D3 levels were noted in KC patients but did not show any statistically significant association with clinical and tomographic parameters. We did not find any serum folic acid abnormalities. However, thyroid dysfunction was seen in KC patients and exhibited a statistically significant association with tomographic parameters.