Ermis Serhat, Ozal Ece, Celen Arabaci Idil, Tastan Ozlem, Aydın Fahri Onur, Karapapak Murat, Kepez Yıldız Burçin, Ozal Sadık Altan
University of Health Sciences, Basaksehir Cam and Sakura City Hospital, Department of Ophthalmology, Istanbul, Turkey.
Ophthalmic Physiol Opt. 2025 Aug 7. doi: 10.1111/opo.70001.
This study aimed to evaluate whether corneal biomechanical alterations in keratoconus (KC) are associated with changes in the lamina cribrosa (LC), retinal nerve fibre layer (RNFL) and peripapillary microvascular structures by comparing these parameters with healthy controls.
In this prospective, cross-sectional, case-control study, 66 eyes of 66 KC patients and 76 eyes of 76 healthy controls were enrolled. Corneal morphological and biomechanical parameters were measured using Scheimpflug imaging (Pentacam) and a dynamic Scheimpflug analyser (Corvis ST). Posterior segment structures were evaluated using swept-source optical coherence tomography (SS-OCT) and OCT angiography (SS-OCTA). The radial peripapillary capillary plexus (RPCP) density, RNFL thickness and LC parameters (lamina cribrosa thickness [LCT] and lamina cribrosa curvature index [LCCI]) were measured. The relationship between corneal biomechanical parameters and structural changes in the LC was evaluated by correlation analysis.
Biomechanical parameters were significantly poorer in the KC group compared to controls. RNFL thickness and RPCP density were significantly lower in KC patients (p < 0.05). LCT was significantly lower, whereas LCCI was significantly higher in KC patients compared with controls (p < 0.001 for both). Significant correlations were observed between LCT and minimum central corneal thickness (r = 0.26, p = 0.04) and maximum keratometry (r = -0.28, p = 0.03). However, no significant correlations existed between LCCI and biomechanical parameters.
This study suggests that corneal biomechanical changes in KC are associated with structural alterations in the LC, indicating that KC may not be limited to the cornea alone, but may be related to broader ocular collagen involvement.
本研究旨在通过将圆锥角膜（KC）患者的角膜生物力学改变与健康对照者的这些参数进行比较，评估其是否与筛板（LC）、视网膜神经纤维层（RNFL）和视乳头周围微血管结构的变化相关。
在这项前瞻性、横断面、病例对照研究中，纳入了66例KC患者的66只眼和76例健康对照者的76只眼。使用Scheimpflug成像（Pentacam）和动态Scheimpflug分析仪（Corvis ST）测量角膜形态和生物力学参数。使用扫频光学相干断层扫描（SS-OCT）和OCT血管造影（SS-OCTA）评估眼后段结构。测量视乳头周围放射状毛细血管丛（RPCP）密度、RNFL厚度和LC参数（筛板厚度[LCT]和筛板曲率指数[LCCI]）。通过相关性分析评估角膜生物力学参数与LC结构变化之间的关系。
与对照组相比，KC组的生物力学参数明显较差。KC患者的RNFL厚度和RPCP密度明显较低（p < 0.05）。与对照组相比，KC患者的LCT明显较低，而LCCI明显较高（两者均p < 0.001）。观察到LCT与中央角膜最小厚度（r = 0.26，p = 0.04）和最大角膜曲率（r = -0.28，p = 0.03）之间存在显著相关性。然而，LCCI与生物力学参数之间不存在显著相关性。
本研究表明，KC患者的角膜生物力学变化与LC的结构改变相关，这表明KC可能不仅局限于角膜，还可能与更广泛的眼部胶原受累有关。
