Evaluation of corneal and lens properties in patients with systemic sclerosis: a densitometric analysis

Systemic sclerosis can affect vision quality by causing fibrosis in the cornea and lens, as in all organs.

The aim of this work is to evaluate corneal and lens densitometry alongside anterior segment parameters in patients with systemic sclerosis (SSc), and to assess whether subclinical structural changes are detectable using Scheimpflug-based imaging.

This prospective case-control study included 20 patients with SSc and 20 age- and sex-matched healthy controls. All participants underwent comprehensive ophthalmologic examination, including anterior segment imaging using the Pentacam HR system. Corneal and lens densitometry values were recorded in concentric zones and evaluated in the anterior, central, and posterior layers. Additional parameters such as central corneal thickness (CCT), anterior chamber (AC) depth, AC angle, and corneal volume were also assessed.

No statistically significant differences were observed in anterior segment parameters (CCT, AC depth, AC angle, corneal volume) or lens densitometry values between SSc patients and controls (p > 0.05). However, significantly reduced corneal densitometry values were found in the anterior and central layers of the 0-2 mm and 2-6 mm zones in the SSc group (p < 0.05). No significant differences were noted in the posterior corneal layer across all zones.

Although anterior segment and lens parameters appeared unaffected, reduced corneal densitometry in the central optical zone suggests subtle stromal remodelling in patients with long-standing SSc. These microstructural changes may reflect chronic fibrotic remodelling and warrant further investigation.