The macular microvasculature evaluated by OCTA in various stages of keratoconus compared to healthy controls: A cross-sectional study

IF 2.7 3区医学 Q2 ONCOLOGY

Photodiagnosis and Photodynamic Therapy Pub Date : 2026-06-01 Epub Date: 2026-05-20 DOI:10.1016/j.pdpdt.2026.105518

Rana Sorkhabi, Ali Mostafaie, Mohammad Hossein Ahoor, Afshar Teymoorpoor, Rahman Beyrami, Erfan Rezazadeh, Reza Salek, Salar Abed Nikmanesh, Tahereh Attar Gharamaleki, Amin Arasteh

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引用次数: 0

Abstract

Objective

To investigate the macular microvasculature and thickness in keratoconus (KCN) cases with various stagings and compare them with healthy controls.

Design

Cross-sectional.

Methods

110 eyes of 57 KCN cases (35 males and 22 females) and 150 eyes of 75 controls (25 males and 50 females) entered this cross-sectional study. After a thorough ophthalmic examination and corneal tomography with Pentacam, KCN cases were staged using the Amsler–Krumeich classification. All included eyes underwent macular OCTA using the RTVue XR Avanti system, evaluating vessel density in the superficial and deep capillary plexus (SCP and DCP) in various macular segments, the foveal avascular zone (FAZ) area, and the foveal flow area. Linear mixed-effect models were used to compare parameters between groups, adjusted for age and sex, while accounting for inter-eye correlation.

Results

In the KCN group, the majority of eyes were in stages 2 and 4 of KCN, 34 eyes (30.9%) in each stage. 22 eyes (20%) were in stage 1, and 20 eyes (18.2%) were in stage 3. The macular vessel density (VD) adjusted for age and gender was significantly lower in KCN cases compared to the controls in all areas in both superficial and deep capillary plexus, except the parafoveal DCP VD, which showed no significant difference. However, macular thickness did not differ significantly between KCN cases and controls. The macular VD in most areas was also significantly lower in stage 4 cases than in stage 1 cases.

Conclusion

This finding supports the concept that keratoconus may involve posterior segment microvascular alterations in addition to corneal ectasia. Future prospective studies applying standardized OCTA protocols and longitudinal follow-up are needed to determine whether these changes have prognostic value or demonstrate a broader systemic phenotype.

查看原文本刊更多论文

与健康对照者相比，不同阶段圆锥角膜的OCTA评价黄斑微血管：一项横断面研究。

目的：探讨不同分期圆锥角膜（KCN）患者黄斑微血管及厚度的变化，并与健康对照进行比较。设计：横断面方法：57例KCN患者的110只眼（男性35例，女性22例）和75例对照者的150只眼（男性25例，女性50例）进入横断面研究。经过彻底的眼科检查和Pentacam角膜断层扫描后，KCN病例采用Amsler-Krumeich分类进行分期。所有患者均采用RTVue XR Avanti系统行黄斑OCTA检查，评估黄斑各节段浅毛细血管丛和深毛细血管丛（SCP和DCP）的血管密度、中央凹无血管区（FAZ）区域和中央凹血流区。线性混合效应模型用于比较各组之间的参数，调整了年龄和性别，同时考虑了眼间相关性。结果：KCN组以2期、4期为主，各期34眼（30.9%）。1期22眼（20%），3期20眼（18.2%）。经年龄和性别调整后，KCN患者的黄斑血管密度（VD）在浅、深毛细血管丛的所有区域均显著低于对照组，但正中凹旁DCP VD差异无统计学意义。然而，黄斑厚度在KCN病例和对照组之间没有显著差异。大部分黄斑VD在4期病例中也明显低于1期病例。结论：这一发现支持了圆锥角膜除角膜扩张外还可能涉及后段微血管改变的观点。未来的前瞻性研究需要应用标准化的OCTA协议和纵向随访来确定这些变化是否具有预后价值或显示更广泛的系统性表型。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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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.