Evidence map›Paper›PMID 40859367›Full record

ReviewInternational journal of retina and vitreous2025

Retinal and choroidal changes following corneal collagen cross-linking in keratoconus: a systematic review and meta-analysis of OCT and OCTA studies.

Kia Bayat, Aryan Seraj, Parisa Pooyan, Sepehr Feizi, Mozhgan Rezaei Kanavi, Marco A Zarbin, Hamid Ahmadieh

Abstract readReview
In one paragraph

Review in International journal of retina and vitreous, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers.

0numbers the graph read from it
0cells of the map it votes in
2citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

2 citing papers in PubMed.

  1. Article
  2. Review
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

7 authors.

Kia BayatOphthalmic Research Center, Research Institute for Ophthalmology and Vision Science, Shahid Beheshti University of Medical Sciences, Tehran, Iran. kiabayat1998@gmail.com.
Aryan Seraj *School of Medicine, Shahid Beheshti University of Medical Sciences, Tehran, Iran.
Parisa Pooyan *School of Medicine, Shahid Beheshti University of Medical Sciences, Tehran, Iran.
Sepehr FeiziOphthalmic Research Center, Research Institute for Ophthalmology and Vision Science, Shahid Beheshti University of Medical Sciences, Tehran, Iran.
Mozhgan Rezaei KanaviOcular Tissue Engineering Research Center, Research Institute for Ophthalmology and Vision Science, Shahid Beheshti University of Medical Sciences, Tehran, Iran.
Marco A ZarbinInstitute of Ophthalmology and Visual Science, Rutgers New Jersey Medical School, Newark, NJ, USA.
Hamid AhmadiehOphthalmic Research Center, Research Institute for Ophthalmology and Vision Science, Shahid Beheshti University of Medical Sciences, Tehran, Iran.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

Corneal collagen cross-linking (CXL) is widely used to halt the progression of keratoconus by biomechanically strengthening the corneal stroma; however, its potential effects on retina and choroid remain unclear. This systematic review and meta-analysis synthesized current evidence on structural and microvascular changes in the posterior segment following CXL in patients with keratoconus, assessed by optical coherence tomography (OCT) and OCT angiography (OCTA). A comprehensive search of PubMed, EMBASE, and Web of Science was performed up to May 24, 2025. Random-effects meta-analysis using Hedges' g was applied to pool quantitative data. In addition, studies that met the eligibility criteria but lacked sufficient data for quantitative synthesis were qualitatively assessed and included in the descriptive analysis. Ten studies involving 233 eyes from 215 keratoconus patients were included. Meta-analysis demonstrated no significant change in central macular thickness at 1 month (Hedges's g = -0.15; 95% confidence interval [CI]: -0.44 to 0.13; p = 0.30) or 6 months (Hedges's g = -0.12; 95% CI: -0.47 to 0.22; p = 0.48). Subfoveal choroidal thickness also remained unchanged at 1 month (Hedges's g = -0.14; 95% CI: -0.45 to 0.17; p = 0.37). Sensitivity analyses confirmed the robustness of these results. In the qualitative synthesis, parameters demonstrated overall stability, aside from a few exceptions. In conclusion, current evidence suggests that CXL does not result in clinically meaningful changes in posterior segment structure or microvasculature in keratoconus patients. These findings support the posterior segment safety of CXL.

Indexed as

ChoroidCorneal cross-linkingKeratoconusOptical coherence tomographyOptical coherence tomography angiographyRetina

Identifiers

PMID40859367
PMCPMC12379409

What Socratic holds

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Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the Socratic graph.