Macular Choroidal Thickness in Keratoconus: Systematic Review and Meta-Analysis of Current Evidence

Area of Science:

• Ophthalmology
• Corneal Diseases
• Retinal Imaging

Background:

• Keratoconus (KC) is a progressive corneal disease.
• Choroidal changes may play a role in KC pathophysiology.
• Optical coherence tomography (OCT) is crucial for macular assessment.

Purpose of the Study:

• To investigate macular choroidal thickness changes in keratoconus patients.
• To synthesize existing evidence comparing choroidal thickness in KC versus controls.
• To evaluate the role of choroidal thickness in keratoconus progression.

Main Methods:

• Systematic literature search of PubMed and Scopus databases.
• Meta-analysis of 10 studies comparing choroidal thickness in KC and healthy controls.
• Statistical analysis using Mean Difference (MD) and 95% confidence intervals (CI).

Main Results:

• Patients with keratoconus exhibited significantly increased subfoveal choroidal thickness compared to controls (MD = 43.94, 95% CI = 17.36-70.51, p = 0.001).
• High heterogeneity (I² = 95%) was observed, indicating variability across studies.
• Sensitivity analysis confirmed the robustness of the findings.

Conclusions:

• Eyes with keratoconus demonstrate significantly greater macular choroidal thickness than healthy eyes.
• These findings suggest a potential link between choroidal alterations and keratoconus.
• Further longitudinal studies are needed to explore the impact of disease severity on choroidal changes in KC.