Researchers in Iran recently discovered low serum levels of certain antioxidants in patients with keratoconus (KCN), pointing to a possible new therapy to help ward off early progression.

After assessing serum levels of zinc (Zn), calcium, magnesium, iron, copper (Cu) and selenium (Se) in 50 patients with advanced KCN and 50 healthy controls, the researchers noted lower zinc, copper and selenium in the KCN group. No statistical difference existed between groups for calcium, magnesium or iron.

The study further explains that copper deficiency is known to cause oxidative stress in tissues and abnormal collagen synthesis; zinc deficiency also impairs the breakdown of collagen and induces oxidative stress in tissues; “these changes can be the underlying pathology involved in loss of corneal rigidity, thinning and formation of a cone due to the weakened tissue being unable to withstand intraocular pressure forces that finally result in KCN,” the study says.

This was the first investigation to report systemic selenium levels—and low ones at that—in patients with advanced KCN, the researchers said. Selenium deficiency plays a role in the etiology of autoimmune diseases such as thyroid dysfunction and various infections. In addition, other studies have suggested that “selenium–lactoferrin eye drops regulate oxidative stress in the corneal epithelium and are recommended for treatment of dry eye,” according to the study.

 “These results suggest the possible role of antioxidant activity of Zn, Cu and Se in the etiology of advanced KCN, which then suggests the possibility of treatment of KCN by supplementation with these trace elements,” the researchers conclude. “If such treatment could slow the progression of KCN, then the need for keratoplasty might be reduced.”

Bamdad S, Owji N, Bolkheir A, et al. Association between advanced keratoconus and serum levels of zinc, calcium, magnesium, iron, copper, and selenium. Cornea. June 07, 2018. [Epub ahead of print].