Sun Jessica A, Johnson Grace, Saini Chhavi, Chang Aimee C, Devlin Julia, Wang Haobing, Chung In Young, Dohlman Thomas H, Paschalis Eleftherios I, Chodosh James, Shen Lucy Q
Department of Ophthalmology, Massachusetts Eye and Ear, Harvard Medical School, Boston, MA.
Schepens Eye Research Institute, Massachusetts Eye and Ear, Harvard Medical School, Boston, MA; and.
Cornea. 2025 Jan 14;44(8):998-1009. doi: 10.1097/ICO.0000000000003805.
To report on optical coherence tomography angiography (OCTA) in patients with a type 1 Boston keratoprosthesis (KPro) and determine its feasibility through assessment of imaging artifacts.
KPro and non-KPro subjects were matched for age, gender, and glaucoma diagnosis. OCTA images of the peripapillary optic nerve were obtained, reviewed by 2 readers masked to the diagnosis for artifacts and usability, and used for microvascular measurements.
KPro subjects (n = 18) had worse visual acuity than non-KPro (n = 36) subjects (LogMAR mean ± standard deviation 0.36 ± 0.30 vs. 0.07 ± 0.11, P < 0.001) and a greater proportion were monocular (56% vs. 3%, P < 0.001). OCTA from KPro eyes had more artifacts per scan than images from non-KPro eyes (4 ± 2 vs. 2 ± 2, P < 0.001). About 33% of KPro images were useable based on having image quality score above 40 and artifact in less than 10% of the peripapillary region. Worse visual acuity (odds ratio [OR] 0.01, 95% confidence interval [CI] 2 x 10 -4 -0.30, P = 0.02) and KPro (OR 0.19, 95% CI 0.05-0.63, P = 0.008) were associated with lowered likelihood of usability. Useable OCTA from 3 KPro eyes with glaucoma demonstrated microvascular defects in the inferior peripapillary region and lower vessel density and flow compared with 3 KPro eyes without glaucoma.
This is the first study assessing OCTA in KPro patients and identified a higher incidence of artifacts that may be associated with the KPro optic. About 33% of KPro images were useable for microvascular measurements, supporting further OCTA research in this population to assess vascular pathology of glaucoma.
报告1型波士顿人工角膜（KPro）患者的光学相干断层扫描血管造影（OCTA）情况，并通过评估成像伪影确定其可行性。
KPro组和非KPro组受试者在年龄、性别和青光眼诊断方面进行匹配。获取视乳头周围视神经的OCTA图像，由2名对诊断不知情的阅片者对伪影和可用性进行评估，并用于微血管测量。
KPro组（n = 18）患者的视力比非KPro组（n = 36）患者差（平均LogMAR视力±标准差0.36±0.30 vs. 0.07±0.11，P < 0.001），且单眼患者的比例更高（56% vs. 3%，P < 0.001）。KPro眼的OCTA每次扫描产生的伪影比非KPro眼的图像更多（4±2 vs. 2±2，P < 0.001）。基于图像质量评分高于40且视乳头周围区域伪影少于10%，约33%的KPro图像可用于分析。视力较差（优势比[OR] 0.01，95%置信区间[CI] 2×10 -4 -0.30，P = 0.02）和KPro（OR 0.19，95% CI 0.05 - 0.63，P = 0.008）与可用性降低相关。来自3只患有青光眼的KPro眼的可用OCTA显示，与3只没有青光眼的KPro眼相比，视乳头下方区域存在微血管缺陷，血管密度和血流较低。
这是第一项评估KPro患者OCTA的研究，发现伪影发生率较高，可能与KPro光学部件有关。约33%的KPro图像可用于微血管测量，支持在该人群中进一步开展OCTA研究以评估青光眼的血管病变。
