Retinal and choroidal microvasculature is altered after strabismus surgery

Abstract

Purpose To evaluate the retinal and choroidal microvasculature after strabismus surgery using swept-source optical coherence tomography angiography (OCTA) Methods Thirty-three eyes of 33 patients who underwent horizontal rectus surgery for strabismus were included in this retrospective study. The unoperated fellow eyes were used as the control group. The macular microvasculature was assessed using a 3 × 3 scan pattern centred on the fovea preoperatively, and one week and one month postoperatively. The vessel density (VD) of superficial capillary plexus (SCP), deep capillary plexus (DCP), and choriocapillaris (CC) were automatically analyzed. The foveal avascular zone (FAZ) was calculated manually using the tool of the device. Results The VD in SCP demonstrated a significant difference between operated and fellow eyes at one week (p = 0.017). Moreover, a significant increase was observed in the mean VD values in SCP of operated eyes after surgery (p = 0.037). The VD in DCP exhibited no significant differences between operated and fellow eyes before and after strabismus surgery. However, there was a significant difference in VD was observed between operated and fellow eyes one week after surgery (p = 0.001). The mean VD in CC was significantly increased in the operated eyes one week after surgery compared to preoperative values (p = 0.006). Conclusion This study revealed that strabismus surgery may cause transient alterations both in retinal and choroidal microcirculation in the early postoperative period.

Changes in retinal and choroidal blood flow after one or two horizontal rectus muscle surgeries by optical coherence tomography angiography

“…In our study, we observed an increase in SVC and CVI in the nasal sector of the perifoveal region 1 week after surgery, which may result from an inflammatory response induced by surgery or a compensatory mechanism to prevent hypoperfusion after injury to the ACAs [ 22–25 ]. Earlier color Doppler ultrasound studies have shown an increase in the retrobulbar blood flow velocity 1 day after single or double rectus muscle surgeries, and the increase was thought to be the expected outcome in an inflammatory state [ 2 , 9 ].…”

“…It allows visualization of the posterior pole microvasculature without dye injection and allows assessment of vessel density (VD) in specific retina and choroid layers [ 21 ]. Only a few recent OCTA studies have evaluated microvascular changes in the retinal capillaries plexus and choroidal capillaries plexus after strabismus surgery, which have provided diverse results depending on the different times of follow-up [ 22–25 ]. Besides, they have not investigated whether there is a difference in the retinal and choroid changes after one or two horizontal rectus muscle surgeries [ 22–25 ].…”

“…Only a few recent OCTA studies have evaluated microvascular changes in the retinal capillaries plexus and choroidal capillaries plexus after strabismus surgery, which have provided diverse results depending on the different times of follow-up [ 22–25 ]. Besides, they have not investigated whether there is a difference in the retinal and choroid changes after one or two horizontal rectus muscle surgeries [ 22–25 ]. The aim of this study was to use SS-OCTA to assess macular vessel density and thickness of retinal and choroid 1 week after one or two horizontal rectus muscle surgeries in strabismus patients, which provided more objective and accurate measurements.…”