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

Abstract

Purpose

To evaluate the retinal and choroidal microvasculature after one or two horizontal rectus muscle surgeries in strabismus patients using swept-source optical coherence tomography angiography (SS-OCTA).

Methods

30 eyes of 26 patients who underwent horizontal rectus muscle surgery were included in this study. Group A, A’ and Group B , B’ respectively consisted preoperative and postoperative measurements of patients who underwent one or two horizontal rectus muscle surgeries. We analyzed the vessel density (VD) of the superficial vascular complex (SVC), the deep vascular complex (DVC), the choriocapillary layer (CC), choroidal vascular index (CVI), choroidal thickness (T-Ch) and retinal nerve fiber layer thickness (T-RNFL) preoperatively, and one week postoperatively.

Results

Only in the nasal sector of the perifoveal zone, the VD in SVC demonstrated a significant increase in Group A’ (p = 0.027). There was a statistically significant difference in the VD changes of SVC between Group A and Group B (p = 0.043). The VD in DVC did not change significantly in the whole macular compared with the preoperative. Moreover, in both Group A’ and Group B’, the VD in CC showed a reduction in a single sector of the parafoveal area (p < 0.05). Group A’ have increased CVI in the nasal sector of the perifoveal region (p = 0.008). In addition, the T-Ch increase in the perifoveal region was more significant in Group B’ than in Group A’ (p < 0.05). Group A’ showed statistically significant decreases in T-RNFL in the foveal and parafoveal regions (p < 0.05).

Conclusion

This study revealed that the increase in choroidal thickness was more significant after two rectus muscle surgery. In addition, there were microvascular changes in sectional macular regions after strabismus surgery. OCTA is an excellent way to study the impact of strabismus surgery on the macular structure and blood flow.

Key Messages

We used SS-OCTA, which provided more objective and accurate measurements, to assess macular vessel density and thickness of retinal and choroid after one or two horizontal rectus muscle surgeries.

Keywords:

• Strabismus
• horizontal rectus muscle surgery
• microvasculature
• thickness
• OCTA

Acknowledgment

The authors thank all of the patients who participated in this study.

Author contributions

DH, YX, CC, HZ, YX and ZC were involved in the conception and design. DX, TC, and YM collected the data. DX, TC, DH, HZ and YX were involved in the analysis and interpretation of the data. DX drafted the manuscript. DH, HZ and YX contributed to the critical revision of the manuscript for important intellectual content and approved the final version of the manuscript. All authors have read and agreed to be accountable for all aspects of the work.

Disclosure statement

No potential conflict of interest was reported by the author(s).

Data availability statement

The data that support the findings of this study are available from the corresponding author, DH and HZ, upon reasonable request.

Additional information

Funding

This work was supported by the National Natural Science Foundation of China under Grant NO. 42201457 and the Fundamental Research Funds for the Central Universities under Grant NO. 2042022kf1095.