Retinal Vascular Density Increase in Crohn's Disease: A Cross-sectional Optical Coherence Tomography Angiography Study
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Background Inflammatory bowel diseases (IBD) cause systemic inflammation that may affect retinal vasculature. This study evaluated retinal microvascular changes in Crohn's disease (CD) and ulcerative colitis (UC) patients using optical coherence tomography angiography (OCTA). Methods This cross-sectional study included 82 IBD patients (44 UC, 38 CD) and 40 healthy controls. All participants underwent OCTA imaging (AngioVue, Optovue Inc.). Parameters measured: superficial/deep capillary plexus (SCP/DCP) vessel density, foveal avascular zone (FAZ) area, and non-flow area. Disease activity was assessed using Mayo score (UC) and Crohn's Disease Activity Index (CDAI). Statistical analysis used ANOVA and chi-square tests (SPSS v23.0). Results Higher vascular density was observed in Crohn’s disease (CD) patients compared to healthy controls and UC patients in multiple OCTA parameters (SCP and DCP densities). Additionally, FAZ and non-flow area values were significantly lower in the CD group. These findings suggest increased retinal vascular density in CD, a phenomenon not previously reported. Conclusions OCTA reveals increased retinal vascular density and reduced FAZ in CD patients, suggesting distinct retinal microvascular changes in CD versus UC. These findings support OCTA as a potential biomarker for IBD-related systemic inflammation.