OCT-Based Retinal Parameters and Choroidal Vascular Indices Predicting Response to Anti-TNF-α Therapy in Inflammatory Bowel Disease.

Abstract

Objective: This study aims to quantitatively analyze retinal structural parameters and choroidal vascular indices using optical coherence tomography (OCT) technology, in order to evaluate the predictive value of these ocular biomarkers for the progression to retinopathy in patients with inflammatory bowel disease (IBD), and to analyze the predictive efficacy of changes in OCT parameters for the treatment response to TNF-α inhibitor therapy in IBD patients.

Methods: A retrospective analysis was conducted on 180 IBD patients treated between January 2022 and December 2023 [including 75 patients with Crohn's disease (41.67%) and 105 patients with ulcerative colitis (58.33%)]. Patients were divided into groups based on disease progression characteristics. The progression group consisted of IBD patients who developed newly detected retinopathy during follow-up (n=64), while the stable group included those without retinopathy and with maintained intestinal disease stability (n=116). All patients underwent OCT examination. Retinal parameters-including retinal nerve fiber layer (RNFL), ganglion cell inner-plexiform layer (GCIPL), and central macular thickness (CMT)-as well as choroidal vascular indices-such as choroidal vascularity index (CVI), choroidal capillary vascular density (CC-VD) and choroidal thickness in the macular central sulcus (SF-CT)] were compared between the two groups. Receiver operating characteristic (ROC) curve analysis was performed to evaluate the predictive performance of these parameters for diseases outcomes in IBD patients. Nomograms and calibration curves were constructed to develop a prediction model for IBD progression. Patients in the progression group received TNF-α inhibitor (adalimumab) therapy. ROC analysis was conducted to assess the predictive efficacy of retinal parameters and choroidal vascular indexes for the response to biologic therapy.

Results: The area under the curve (AUC) values for predicting disease outcomes in IBD patients were 0.907 for RNFL, 0.939 for GCIPL, and 0.871 for CMT. The AUC values for CVI, CC-VD, and SF-CT in predicting disease outcomes were 0.918, 0.965 and 0.946, respectively. The nomogram indication models constructed using retinal parameters and choroidal vascular indicators demonstrated high accuracy. Moreover, GCIPL, CVI and CC-VD showed high predictive value for the response to biologic therapy in the progression group, with AUC values of 0.952, 0.941, and 0.993, respectively.

Conclusion: Retinal parameters and choroidal vascular indexes based on OCT technology can effectively predict disease outcomes in patients with IBD and provide valuable guidance for evaluating the response to biologic therapy.