Analysis of Choroidal Vascularity Index in Keratoconus Patients Using Swept-Source Optical Coherence Tomography-Based Binarization Techniques

Gutierrez-Bonet, R.; Ruiz‐Medrano, Jorge; Biarnés, Marc; Rasheed, Mohammed Abdul; Vupparaboina, Kiran Kumar; Chhablani, Jay; Ruiz-Moreno, José M.

doi:10.1155/2020/1682463

Cited by 14 publications

(36 citation statements)

References 36 publications

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“…The median age was 24.00 years (range [14][15][16][17][18][19][20][21][22][23][24][25][26][27][28][29][30] and individuals in our sample were predominately men (76.3%). Median best corrected visual acuity (BCVA) was 0.90 Snellen (range 0.10-1.00), with glasses or contact lenses.…”

Section: Resultsmentioning

confidence: 86%

“…The recent findings of increased CT in KC patients raised the question of whether CT could help to differentiate progressive from non-progressive disease [23][24][25][26][27] . Until now all evaluations of KC progression were centered in tomographic and biomechanical corneal parameters 21,22,[28][29][30][31] , but the recently raised questions of an inflammatory hit in the disease and an increased CT in those patients opens new research possibilities.…”

Section: Discussionmentioning

confidence: 99%

“…Changes in the Choroidal Thickness (CT) profile in KC patients have recently been described 23 – 27 , however, the exact changes taking place in the choroid itself are still unclear. The more recent theories about the pathophysiology of KC hint to a possible inflammatory component, which might explain the increase in their CT profile compared to a healthy population 6 , 7 , 23 , 24 .…”

Section: Introductionmentioning

confidence: 99%

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Increased choroidal thickness is not a disease progression marker in keratoconus

Pinheiro-Costa

Correia

Pinto

et al. 2020

Sci Rep

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The recent findings of increased Choroidal Thickness (CT) in Keratoconus (KC) patients raised the question of whether CT could be an indicator of progressive KC. To test this hypothesis, we evaluated and compared the choroidal profile in progressive and non-progressive KC. We ran a cross-sectional observational study in 76 patients diagnosed with KC, age 14–30, to assess KC progression. Progression was defined as when at least two of the studied variables confirmed progression (Kmax, Km, PachyMin, D-Index, Astig, K2, 3 mm PCR). Included patients performed a Spectralis Optical Coherence Tomography (OCT) with enhanced depth image (EDI) technology to evaluate choroidal profile. Choroidal measurements were taken subfoveally and at 500 µm intervals from the fovea, in 7 different locations, and compared between groups. Multivariate linear regression analyses were also performed to assess the influence of CT in KC progression. Thirty-six eyes (47.4%) were classified as KC progressors. The mean subfoveal CT observed in the total sample was 382.0 (± 97.0) μm. The comparison between groups (progressive and non-progressive KC) showed no differences in the locations evaluated (mean subfoveal CT difference between groups was 2.4 μm, p = 0.915). In the multivariate analysis CT seems not be influenced by KC progression (B = 6.72 μm, 95% CI − 40.09 to 53.53, p = 0.775). Assessment of choroidal profile does not appear to be a useful tool to differentiate progressive and non-progressive KC. Further research is needed in order to better understand the role of choroid in KC.

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Section: Resultsmentioning

confidence: 86%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Increased choroidal thickness is not a disease progression marker in keratoconus

Pinheiro-Costa

Correia

Pinto

et al. 2020

Sci Rep

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“… 30 Furthermore, the same authors recently studied the exact components of the thicker choroid in KC and found that vascular region and corrected choroidal percentage of vascularity are also statistically increased in KC patients when compared with healthy controls. 31 If these findings are only an association without any role in the KC, or if they are part of a complex pathogenesis process is still unknown. The overall evidence and our results support the idea that inflammatory mechanisms could contribute both to KC activity and increase of CT, claiming a role for inflammation and potentially for atopy in its pathophysiology.…”

Section: Discussionmentioning

confidence: 99%

The Role of Atopy in the Choroidal Profile of Keratoconus Patients

Moleiro¹,

Aires²,

Alves³

et al. 2021

OPTH

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Purpose Although classically classified as a non-inflammatory condition, an inflammatory basis for keratoconus (KC) appears to be a growing evidence. Recently, it has been shown that KC patients have an increased choroidal thickness (CT). Among inflammatory disorders, atopy has been associated with KC development; therefore, the aim of this study was to evaluate if the increased CT in patients with KC is related to atopy. Methods This is an analytical cross-sectional study of patients with KC. Patients were classified as atopic and non-atopic according to their atopy history (allergic rhinoconjunctivitis (AR), asthma (AA) and/or atopic dermatitis (AD)) and were also classified based on their eye rubbing habits. Choroidal profile of all subjects was evaluated using a Spectralis optical coherence tomography (OCT) device with enhanced depth imaging (EDI) mode. CT was measured and compared between groups at the center of the fovea and at 500 µm intervals along a horizontal section. A multivariable analysis, adjusted for sex, age, spherical equivalent, history of medication and atopy, was performed to assess the influence of atopy in CT. Results Of the 80 patients included, 51 were atopic and 29 non-atopic. Atopic patients showed a thicker choroid in every measured location than the non-atopic patients (mean subfoveal CT 391.53 µm vs 351.17 µm, respectively), although the differences were not statistically different. The multivariable analysis revealed that being atopic makes the choroid statistically thicker, on average, 55.14 µm, when compared to non-atopic patients (p=0.043). Furthermore, patients who are frequent eye rubbers have significantly thicker choroids than non-rubbers (p=0.004). Conclusion Although some results do not reach statistical significance, atopic KC patients seem to have thicker choroids compared with non-atopic KC patients, suggesting a possible role for atopy in the choroidal profile of KC. This constitutes a completely new sight in this field of research that needs further investigation.

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“…OCT angiography (OCT-A) is a non-invasive imaging tool that allows detailed visualization of the retinal microvasculature to be obtained. Therefore, in this study, we compared the retinal vascularization and corneal parameters of patients with diagnosed KC with those of a control group using SS-OCT [ 14 , 15 , 16 ].…”

Section: Introductionmentioning

confidence: 99%

Assessment of the Retinal Vessels in Keratoconus: An OCT Angiography Study

Wylęgała

Szkodny

Fiolka

et al. 2022

JCM

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This study investigated vascular density and foveal avascular zone (FAZ) parameters using optical coherence tomography angiography (OCT-A) in patients with keratoconus (KC). Participants with KC and healthy controls were included and underwent best-corrected visual acuity (BCVA), keratometry, anterior segment OCT, and macular OCT-A examinations. Of the 70 subjects (mean age 42.9 ± 15.31 years), 79 KC and 47 healthy eyes were included. Significant reductions in the KC group were recorded for the FAZ area, with a mean (±SD) of 0.19 ± 0.12 vs. 0.25 ± 0.09 mm2 p < 0.001. Central vascular density in KC patients was lower compared with the controls: 6.78 ± 4.74 vs. 8.44 ± 3.33 mm−1 p = 0.049; the inner density was also decreased in the study group (13.64 ± 5.13 vs. 16.54 ± 2.89 mm−1, p = 0.002), along with the outer density (14.71 ± 4.12 vs. 16.88 ± 2.42 mm−1, p = 0.004) and full density (14.25 ± 4.30 vs. 16.57 ± 2.48) p = 0.003. Furthermore, BCVA was positively correlated with central vascular density (R = 0.42 p = 0.004, total R = 0.40, p = 0.006) and inner density (R = 0.44, p = 0.002) in patients with KC but not in controls. Additionally, we found a correlation between K2 and inner vascular density (R = −0.30, p = 0.043) and central epithelium thickness and outer density (R = 0.03, p = 0.046). KC patients had lower macular vascular density and a smaller FAZ than healthy participants. The BCVA in KC patients was correlated with the vascular density.

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Analysis of Choroidal Vascularity Index in Keratoconus Patients Using Swept-Source Optical Coherence Tomography-Based Binarization Techniques

Cited by 14 publications

References 36 publications

Increased choroidal thickness is not a disease progression marker in keratoconus

Increased choroidal thickness is not a disease progression marker in keratoconus

The Role of Atopy in the Choroidal Profile of Keratoconus Patients

Assessment of the Retinal Vessels in Keratoconus: An OCT Angiography Study

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