Purpose: Keratoconus may be associated with imbalances of sex hormones such as reduced testosterone levels in affected males. In this study, an evolutionary and natural mechanism to increase testosterone levels in males via exposure to the synthetic female pheromone fortidin was evaluated. Materials and methods: In a precursor study n = 16 healthy young males were exposed to Placebo, 2 mg fortidin (5 mL of a 0.04% fortidin solution), and 4 mg fortidin (5 mL of a 0.08% fortidin solution). The testosterone levels were measured before and after the exposure. The pre-exposure testosterone levels were measured three times and the postexposure testosterone level only once in the same n = 16 individuals. The n = 16 mean and standard deviation of the n = 48 pre-exposure measurements in comparison to the n = 16 post-exposure data were statistically analyzed. Results: The exposure to 4 mg fortidin (5 mL of a 0.08% fortidin solution) increases the measured testosterone level by 28.8%. This increase in testosterone level is statistically significant (p < 0.05). The increase of the testosterone level by the lower concentration was not statistically significant. Conclusion: The exposure of young healthy men to 4 mg fortidin (5 mL solution containing 0.08% fortidin) results in a significant increase in their testosterone levels. This mechanism may be important in the future for the prevention and/or treatment of keratoconus. Further studies are in progress.

Background: Keratoconus (KC) has been classically defined as a progressive, noninflammatory condition, which produces a thinning and steepening of the cornea. Recent studies have shown a significant role of proteolytic enzymes, cytokines, and free radicals. It seems more appropriate to classify KC as quasi-inflammatory (inflammatory-related) rather than noninflammatory. Purpose: The aim of the study was to detect matrix metalloproteinase-9 (MMP9) in KC patients with no history of allergy to determine the inflammatory element of KC using an inflammaDry test. Patients and methods: This cross-sectional pilot diagnostic study was done on 30 eyes of 30 patients diagnosed as KC with no history of allergy at Kasr AlAiny Hospital during the period from April 2021 to November 2021. All participants were subjected to a full ophthalmological examination (including history taking, best corrected visual acuity testing, slit-lamp examination, and dilated fundus examination), Pentacam correlation, and inflammaDry test. Results: The mean age in our study was 25.5 (±8.5 years). About 20% of patients were male and 80% were female. About 17 eyes (56.70%) were right side right eye (OD) and 13 (43.30%) were left side left eye (OS). The InflammaDry test was positive in 24 patients (80%) and negative in 6 patients (20%). Conclusion: Matrix metalloproteinase-9 was overexpressed in tear film of a sample of Egyptian KC patients. This supports the hypothesis that inflammatory signaling may be a critical driver of disease pathogenesis.

Aim: To study the prevalence of keratoconus in an ophthalmology practice center in Medellin, Colombia. Materials and methods: A retrospective cross-sectional study was conducted at the CES clinic. A sample of 274 patients evaluated between 2017 and 2019 was used. Their clinical history was reviewed in search of the diagnosis of keratoconus, demographic variables, and others such as allergic conjunctivitis, atopy, and eye rubbing. A bivariate analysis was performed between the characteristics of the patients and keratoconus using the Chi-square and student's t-tests. Results: The prevalence of keratoconus was found to be 2.6% in the studied population, affecting 85.7% of women and 14.3% of men (p 0.097). The mean age of the population with keratoconus was 37.6 ± 7.9. The prevalence of atopy (37.5%) and allergic conjunctivitis (71.4%) was higher in patients with keratoconus (p <0.05). Conclusion: The prevalence of keratoconus presents an important variability according to the geographical area of residence of the population studied; the one found in this study is similar to that reported in centers in other areas of Colombia and Latin America. More studies are required to obtain epidemiological data comparable with the population prevalence of the rest of the world.