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Safety of accelerated corneal collagen cross-linking in keratoconus patients on the basis of macular segmentation

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Abstract

Purpose

To investigate the safety of accelerated corneal collagen cross-linking (A-CXL) in patients with keratoconus on the basis of thickness analysis measurements of retinal layers and retinal morphology.

Study Design

This was a retrospective and comparative study.

Methods

The study included 64 eyes of 32 patients with keratoconus disease. One eye of the patients underwent A-CXL for progressive keratoconus (CXL group) and the fellow eye was followed due to the absence of progression. Patients with at least 1-year follow-up after A-CXL were included. Keratometry, pachymetry and corrected-distance visual acuity (CDVA) levels of the patients were compared. The segmentation analysis of the individual retinal layers of the eyes with (CXL group) and without CXL (no CXL group) was compared with spectral domain-optical coherence tomography automatic segmentation program at baseline and at the last follow-up. The thickness of the retinal nerve fiber layer, ganglion cell layer, inner plexiform layer, inner nuclear layer, outer plexiform layer, outer nuclear layer and retina pigment epithelium layer in the central 1-mm subfield defined by the ETDRS was analyzed.

Results

The mean age of keratoconus patients was 23.9 ± 5.4 years, patients were more likely to be male (21/11, 65.6%), and the mean follow-up duration was 13.9 ± 1.5 months. When keratometry, pachymetry and CDVA levels were compared, only a significant difference was found between CDVA at the last follow-up (0.21 vs. 0.11 LogMAR). No significant difference was observed in neither retinal morphology nor segmentation of individual retinal layers at baseline and at the final evaluation (P > 0.05).

Conclusions

It has been observed that the A-CXL protocol did not cause a significant change in both retinal layer thickness and macular morphology.

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Funding

No sources of support and no funding were received for this study. The authors have no financial or proprietary interest in any material or method mentioned.

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Authors and Affiliations

  1. Ophthalmology Department, Kayserı City Training and Research Hospital, Kocasinan, Kayseri, Turkey

    Cemal Ozsaygili & Yener Yildirim

Authors
  1. Cemal Ozsaygili
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  2. Yener Yildirim
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Contributions

CO designed the study and prepared the manuscript. CO and YY provided clinical care to the patient. All authors provide essential contributions to the revision of the study. All authors approved the final manuscript.

Corresponding author

Correspondence to Cemal Ozsaygili.

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Conflict of interest

The authors have no conflicts of interest to report. The authors alone are responsible for the content and writing of this article.

Ethical approval

The Kayseri City Training and Research Hospital institutional ethical board approved the study (Number: 139361349), and written consent from all study subjects was obtained.

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Ozsaygili, C., Yildirim, Y. Safety of accelerated corneal collagen cross-linking in keratoconus patients on the basis of macular segmentation. Int Ophthalmol 41, 3759–3767 (2021). https://doi.org/10.1007/s10792-021-01945-4

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  • DOI: https://doi.org/10.1007/s10792-021-01945-4

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