Résumé
Objective: to compare retinal microcirculation in CD patients and matched controls according to disease severity.Design, setting, and participants: cross-sectional case-control study from November 30, 2020, to February 30, 2021. Patients with moderate (biologics) or severe (biologics + perianal disease and/or digestive resection) CD without ophthalmologic history and age and sex-matched healthy controls were included.Exposures: OCT angiography (OCT-A) imaging (Optovue®, Fremont, CA) were performed in all participants.Main outcomes and measures: quantitative analyzes of vessel density (VD) and flow index (FI) were performed within the macula in superficial capillary plexus (SCP) and deep capillary plexus (DCP). Macular choriocapillaris plexus flow index (CCP-FI) and Foveal Avascular Zone (FAZ) area were analyzed. Analysis of covariance (ANCOVA) was used to characterize the association between imaging parameters and CD severity.Results: 74 CD patients (33 moderate, 41 severe) and 74 controls (66 men [44.6%]; mean [SD] age, 44 [14] years) were analyzed. Compared to controls severe CD had significant reductions in SCP-VD (whole, p=0.009; parafoveal, p=0.006) and a reduction without being significant in SCP-FI (p=0.06). At the level of DCP, VD and FI were not different between the 3 groups (whole VD, p=0.67; parafoveal VD, p=0.71; DCP-FI, p=0.075). FAZ area was significantly increased in severe CD compared with moderate CD (p=0.010) and in severe CD compared with controls (p=0.001).Conclusions and relevance: OCT-A can detect alterations in retinal microcirculation in severe CD patients compared to moderate CD patients and to age and sex-matched controls.