A novel approach: exploring the potential of retinal thickness and microvascular alterations for diagnosing cirrhosis

Abstract

Background: The objective of this study was to investigate the correlation between fundus alterations and cirrhosis through the use of optical coherence tomography angiography (OCTA). Methods: This study involved 17 patients with cirrhosis (34 eyes) and 17 healthy controls (HCs; 34 eyes). The OCTA fundus data were segmented into various layers and regions and categorized according to the subzones of the Early Treatment Diabetic Retinopathy Study for comparison. Results: Patients with cirrhosis had a lower full retinal thickness (RT) in the IS, OS, and ON regions than did healthy controls (HCs) (P < 0.001), and the RT was also lower in the IN and central regions (p<0.05). Additionally, the inner layer RT was lower in the IS, OS, IT, and OT regions in patients with cirrhosis (P < 0.05), and the outer layer RT was lower in the IS, IN, and ON regions in patients with cirrhosis than in HCs (P < 0.05). The ROC curve of the inner RT of the IS region showed a greater sensitivity to the pathological changes associated with the disease, with an AUC of 0.9324 (95% CI: 0.8665-0.9983). Furthermore, compared with HCs, patients with cirrhosis exhibited significantly lower superficial vessel density (SVD) in the IS, OS, IT, and OT regions (P < 0.001) and lower SVD density in the ON and central regions (P < 0.05). The AUC for the IT region was 0.9429 (95% CI: 0.8928–0.9930), indicating good diagnostic sensitivity. Conclusion: The RT and SVD of specific subregions in the macular retina of patients with cirrhosis were lower than those in the macular retina of HCs. OCTA measurement could be a valuable aid for imaging in cirrhosis patients.