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Abstract #125275 Published in IGR 25-2

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

PURPOSE: 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. METHODS: 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. RESULTS: 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. CONCLUSIONS: 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.

Department of Ophthalmology, Massachusetts Eye and Ear, Harvard Medical School, Boston, MA.

Classification:

15 Miscellaneous

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