Quantitative analysis of microvasculature in macular and optic disc regions in keratoconus patients: A systematic review and meta-analysis

IF 2.6 3区医学 Q2 ONCOLOGY

Photodiagnosis and Photodynamic Therapy Pub Date : 2025-08-16 DOI:10.1016/j.pdpdt.2025.104766

Ling Ling , Wei Yan , Yi Zhao , Kaichao Xia , Yiqiao Xing , Yang Yang , Wei Wan , Kaibao Ji

{"title":"Quantitative analysis of microvasculature in macular and optic disc regions in keratoconus patients: A systematic review and meta-analysis","authors":"Ling Ling , Wei Yan , Yi Zhao , Kaichao Xia , Yiqiao Xing , Yang Yang , Wei Wan , Kaibao Ji","doi":"10.1016/j.pdpdt.2025.104766","DOIUrl":null,"url":null,"abstract":"<div><h3>Background</h3><div>Studies have utilized optical coherence tomography angiography (OCTA) to assess vessel density in the macular and optic disc regions among patients with keratoconus (KC); however, the findings have been incongruent. This study aimed to systematically investigate the retinal macular and optic disc microvascular characteristics in patients with KC compared to healthy controls using OCTA.</div></div><div><h3>Methods</h3><div>A comprehensive literature search was performed across multiple electronic databases, including PubMed, Embase, Web of Science, and the Cochrane Library, up to April 2025. The vessel density metrics of the macular and optic disc regions were extracted and analyzed for both keratoconus patients and healthy controls. Mean differences (MDs) with 95 % confidence intervals were calculated to compare continuous variables. Statistical analyses were conducted using Review Manager Version 5.4.1 software.</div></div><div><h3>Results</h3><div>A total of six studies were included in our analysis. The results demonstrated that the macular whole enface superficial vessel density was significantly lower in the keratoconus (KC) group compared to the control group (MD = -4.45, <em>P</em> < 0.00001). Additionally, there were significant differences in foveal superficial and deep vessel densities between the two groups (MD = -3.27, <em>P</em> = 0.001; MD = -3.58, <em>P</em> = 0.0003, respectively). The parafoveal superficial vessel density in the KC group was markedly reduced compared to that of the controls (MD = -6.21, <em>P</em> = 0.0004). For perifoveal vessel density, patients with KC exhibited significantly decreased vessel density in both the superficial and deep capillary plexuses compared to the control group (MD = -5.12, <em>P</em> < 0.00001; MD = -9.16, <em>P</em> = 0.01, respectively). Furthermore, the radial peripapillary capillary (RPC) whole image vessel density was substantially lower in KC eyes than in the control group (MD = -0.89, <em>P</em> = 0.02).</div></div><div><h3>Conclusion</h3><div>The current meta-analysis demonstrated that the vascular density in the macular and optic nerve head regions was reduced in patients with KC, suggesting that retinal microvasculature could serve as a potential biomarker for aiding in the diagnosis of KC.</div></div>","PeriodicalId":20141,"journal":{"name":"Photodiagnosis and Photodynamic Therapy","volume":"55 ","pages":"Article 104766"},"PeriodicalIF":2.6000,"publicationDate":"2025-08-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"Photodiagnosis and Photodynamic Therapy","FirstCategoryId":"3","ListUrlMain":"https://www.sciencedirect.com/science/article/pii/S1572100025002984","RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q2","JCRName":"ONCOLOGY","Score":null,"Total":0}

引用次数: 0

Abstract

Background

Studies have utilized optical coherence tomography angiography (OCTA) to assess vessel density in the macular and optic disc regions among patients with keratoconus (KC); however, the findings have been incongruent. This study aimed to systematically investigate the retinal macular and optic disc microvascular characteristics in patients with KC compared to healthy controls using OCTA.

Methods

A comprehensive literature search was performed across multiple electronic databases, including PubMed, Embase, Web of Science, and the Cochrane Library, up to April 2025. The vessel density metrics of the macular and optic disc regions were extracted and analyzed for both keratoconus patients and healthy controls. Mean differences (MDs) with 95 % confidence intervals were calculated to compare continuous variables. Statistical analyses were conducted using Review Manager Version 5.4.1 software.

Results

A total of six studies were included in our analysis. The results demonstrated that the macular whole enface superficial vessel density was significantly lower in the keratoconus (KC) group compared to the control group (MD = -4.45, P < 0.00001). Additionally, there were significant differences in foveal superficial and deep vessel densities between the two groups (MD = -3.27, P = 0.001; MD = -3.58, P = 0.0003, respectively). The parafoveal superficial vessel density in the KC group was markedly reduced compared to that of the controls (MD = -6.21, P = 0.0004). For perifoveal vessel density, patients with KC exhibited significantly decreased vessel density in both the superficial and deep capillary plexuses compared to the control group (MD = -5.12, P < 0.00001; MD = -9.16, P = 0.01, respectively). Furthermore, the radial peripapillary capillary (RPC) whole image vessel density was substantially lower in KC eyes than in the control group (MD = -0.89, P = 0.02).

Conclusion

The current meta-analysis demonstrated that the vascular density in the macular and optic nerve head regions was reduced in patients with KC, suggesting that retinal microvasculature could serve as a potential biomarker for aiding in the diagnosis of KC.

查看原文本刊更多论文

圆锥角膜患者黄斑和视盘区域微血管的定量分析：一项系统回顾和荟萃分析。

背景：研究利用光学相干断层血管造影（OCTA）评估圆锥角膜（KC）患者黄斑和视盘区域的血管密度；然而，研究结果并不一致。本研究旨在利用OCTA系统地研究KC患者视网膜黄斑和视盘微血管的特征，并与健康对照进行比较。方法：对截至2025年4月的多个电子数据库进行全面的文献检索，包括PubMed、Embase、Web of Science和Cochrane Library。提取圆锥角膜患者和健康对照者黄斑和视盘区域的血管密度指标并进行分析。计算具有95%置信区间的平均差异（MDs）以比较连续变量。使用Review Manager Version 5.4.1软件进行统计分析。结果：我们的分析共纳入了6项研究。结果显示，圆锥角膜（KC）组黄斑全面浅血管密度明显低于对照组（MD = -4.45,P < 0.00001）。此外，两组间中央凹浅、深血管密度差异有统计学意义（MD = -3.27,P = 0.001;MD = -3.58,P = 0.0003）。与对照组相比，KC组中央凹旁浅血管密度明显降低（MD = -6.21,P = 0.0004）。对于凹窝周围血管密度，与对照组相比，KC患者在浅毛细血管丛和深毛细血管丛的血管密度均显著降低（MD = -5.12,P < 0.00001; MD = -9.16,P = 0.01）。此外，KC眼的径向乳头周围毛细血管（RPC）全图像血管密度明显低于对照组（MD = -0.89,P = 0.02）。结论：目前的荟萃分析表明，黄斑和视神经头区域的血管密度在KC患者中降低，这表明视网膜微血管可以作为帮助KC诊断的潜在生物标志物。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

求助全文

约1分钟内获得全文求助全文

来源期刊

Photodiagnosis and Photodynamic Therapy ONCOLOGY-

CiteScore

5.80

自引率

24.20%

发文量

509

审稿时长

50 days

期刊介绍： Photodiagnosis and Photodynamic Therapy is an international journal for the dissemination of scientific knowledge and clinical developments of Photodiagnosis and Photodynamic Therapy in all medical specialties. The journal publishes original articles, review articles, case presentations, "how-to-do-it" articles, Letters to the Editor, short communications and relevant images with short descriptions. All submitted material is subject to a strict peer-review process.