Optical Coherence Tomography Angiography in Patients With the Boston Keratoprosthesis Type 1

Area of Science:

• Ophthalmology
• Medical Imaging
• Glaucoma Research

Background:

• Boston keratoprosthesis (KPro) is a crucial treatment for severe corneal blindness.
• Assessing microvascular changes in KPro patients is vital for understanding glaucoma progression.
• Optical coherence tomography angiography (OCTA) offers non-invasive microvascular imaging.

Purpose of the Study:

• To evaluate the feasibility of OCTA in patients with type 1 Boston keratoprosthesis (KPro).
• To assess imaging artifacts associated with KPro in OCTA scans.
• To determine the usability of OCTA for microvascular measurements in KPro eyes.

Main Methods:

• Matched comparison of KPro and non-KPro subjects based on age, gender, and glaucoma diagnosis.
• Acquisition and masked review of peripapillary optic nerve OCTA images for artifacts and usability.
• Microvascular measurements were performed on usable OCTA scans.

Main Results:

• KPro eyes had significantly worse visual acuity and a higher incidence of artifacts compared to non-KPro eyes.
• Approximately 33% of OCTA images from KPro eyes were deemed usable for analysis.
• Worse visual acuity and the presence of KPro were associated with lower image usability.
• Usable OCTA in KPro patients with glaucoma revealed inferior peripapillary microvascular defects and reduced vessel density.

Conclusions:

• This study is the first to assess OCTA in KPro patients, noting a higher artifact rate.
• About 33% of KPro OCTA images were usable, supporting further research.
• OCTA holds potential for investigating glaucoma-related vascular pathology in KPro recipients.