Macular microcirculation after extraocular muscle surgery: A comparative OCTA study of inferior oblique versus horizontal rectus procedures
European Journal of Ophthalmology, cilt.36, sa.3, ss.737-744, 2026 (SCI-Expanded, Scopus)
- Yayın Türü: Makale / Tam Makale
- Cilt numarası: 36 Sayı: 3
- Basım Tarihi: 2026
- Doi Numarası: 10.1177/11206721261419623
- Dergi Adı: European Journal of Ophthalmology
- Derginin Tarandığı İndeksler: Science Citation Index Expanded (SCI-EXPANDED), Scopus, EMBASE, MEDLINE, Biomedical Reference Collection: Corporate Edition (EBSCO)
- Sayfa Sayıları: ss.737-744
- Anahtar Kelimeler: Strabismus surgery, inferior oblique muscle, optical coherence tomography angiography, macular perfusion, horizontal muscle
- Sağlık Bilimleri Üniversitesi Adresli: Evet
Özet
Purpose: To compare macular microvascular changes after horizontal rectus and inferior oblique (IO) muscle surgeries using swept-source optical coherence tomography angiography (OCTA) and to assess the distinct vascular effects of each surgical approach. Methods: Eighty-two pediatric and adolescent patients with concomitant strabismus underwent unilateral extraocular muscle surgery. Group 1 (n = 43) received horizontal rectus muscle surgery; Group 2 (n = 39) underwent IO weakening surgery. The fellow unoperated eye served as a control. Macular microvasculature was evaluated before surgery, at 1 week, and 1 month postoperatively using a swept-source OCTA system. Vessel density (VD) of the superficial capillary plexus (SCP), deep capillary plexus (DCP), and choriocapillaris (CC), as well as the foveal avascular zone area (FAZ), was quantitatively analyzed. Results: In the horizontal rectus group, SCP VD significantly increased in the 1st week compared to baseline (49.97% ± 2.41% vs. 51.16% ± 3.23%, p = 0.037) and returned to baseline values in the 1st month. A transient increase in CC VD was also observed at the 1st week (p = 0.006). No significant changes occurred in the DCP and FAZ. In the IO group, no significant changes were found in the SCP, DCP, or FAZ. However, a mild, transient increase in CC VD was observed at the 1st week (p = 0.001), which returned to baseline by the 1st month. Conclusion: Horizontal rectus muscle surgery induces significant but transient changes in macular retinal and choroidal perfusion. In contrast, IO muscle surgery induces only localized and temporary choroidal alterations. OCTA may therefore serve as a valuable noninvasive tool for postoperative monitoring of vascular alterations in strabismus surgery.