Neuro-Ophthalmology最新文献

Retinal Vascular Alterations in Chronic Non-Arteritic Anterior Ischemic Optic Neuropathy: A Dynamic Vessel Analyzer Study. 慢性非动脉性前缺血性视神经病变视网膜血管改变：动态血管分析仪研究。

IF 0.6

Neuro-Ophthalmology Pub Date : 2026-09-01 eCollection Date: 2026-01-01 DOI: 10.1080/01658107.2026.2701213

Ammara Sikandar, Mukawish Zahra Malik, Sana Sajid

{"title":"Retinal Vascular Alterations in Chronic Non-Arteritic Anterior Ischemic Optic Neuropathy: A Dynamic Vessel Analyzer Study.","authors":"Ammara Sikandar, Mukawish Zahra Malik, Sana Sajid","doi":"10.1080/01658107.2026.2701213","DOIUrl":"10.1080/01658107.2026.2701213","url":null,"abstract":"Non-arteritic anterior ischemic optic neuropathy (NAION) is the most common cause of acute optic neuropathy in the elderly population and is strongly associated with vascular and microcirculatory abnormalities. We read with interest the study investigating retinal vascular changes in chronic NAION by Dynamic Vessel Analyzer (DVA) measurements. Although the results provide valuable information on the changes of retinal vasculature in NAION, some methodological issues need to be addressed. Among them, we find the possible violation of statistical independence in the case of bilateral disease, the lack of adjustment for important vascular comorbidities, the cautious interpretation of the arteriovenous ratio (AVR) as a surrogate marker of cerebrovascular risk, and the limitations of the retrospective cross-sectional design in establishing predictive value. Future prospective studies with adequate statistical modeling and extensive adjustment for vascular risk factors are necessary to confirm these associations and clarify their clinical significance.","PeriodicalId":19257,"journal":{"name":"Neuro-Ophthalmology","volume":"50 5","pages":"507-508"},"PeriodicalIF":0.6,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13540209/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148888129","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Trochlear Nerve Schwannoma: An Easily Missed Diagnosis. 滑车神经鞘瘤：一个容易被忽视的诊断。

IF 0.6

Neuro-Ophthalmology Pub Date : 2026-06-26 eCollection Date: 2026-01-01 DOI: 10.1080/01658107.2025.2560121

Yung Ju Yoo, Hee Kyung Yang, Jae Hyoung Kim, Ji-Soo Kim, Chae-Yong Kim, Jeong-Min Hwang

{"title":"Trochlear Nerve Schwannoma: An Easily Missed Diagnosis.","authors":"Yung Ju Yoo, Hee Kyung Yang, Jae Hyoung Kim, Ji-Soo Kim, Chae-Yong Kim, Jeong-Min Hwang","doi":"10.1080/01658107.2025.2560121","DOIUrl":"10.1080/01658107.2025.2560121","url":null,"abstract":"Identification of the trochlear nerve on magnetic resonance (MR) imaging is challenging because it is the thinnest cranial nerve and courses horizontally parallel to the transverse imaging plane. These anatomical features lead to difficulties in detecting small trochlear nerve schwannomas. We identified four cases of presumed small trochlear schwannomas which had been underdiagnosed at outside hospitals due to suboptimal imaging protocols - specifically the absence of gadolinium administration or the lack of high-resolution imaging tailored to the trochlear nerve. In our repeat MR imaging, we employed a high-resolution imaging (voxel size: 0.3 × 0.3 × 0.25 mm), enabling visualization of the entire nerve path within the perimesencephalic cistern. Additional sequences included thin-section postcontrast T1-weighted imaging and orbital coronal T2-weighted imaging. All tumors exhibited clear contrast enhancement and were accurately localized to the trochlear nerve on high-resolution imaging. Orbital coronal images showed ipsilateral atrophy of the superior oblique in all patients. Imaging and clinical findings were reviewed and compared with previously reported cases in the literature. Trochlear nerve schwannomas are rare and often overlooked due to their small size and inconspicuous imaging findings. High-resolution MR imaging tailored for the trochlear nerve is a robust technique to diagnose small trochlear nerve schwannomas.","PeriodicalId":19257,"journal":{"name":"Neuro-Ophthalmology","volume":"50 4","pages":"334-343"},"PeriodicalIF":0.6,"publicationDate":"2026-06-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13313255/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148352615","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Role of DOTATATE PET Imaging in Meningiomas with Neuro-Ophthalmic Implications. DOTATATE PET成像在脑膜瘤与神经眼科的关系中的作用。

IF 0.6

Neuro-Ophthalmology Pub Date : 2026-06-01 eCollection Date: 2026-01-01 DOI: 10.1080/01658107.2026.2639108

Samir Touma, Tracy Aoun, Lahoud Touma, Katie Luneau

{"title":"Role of DOTATATE PET Imaging in Meningiomas with Neuro-Ophthalmic Implications.","authors":"Samir Touma, Tracy Aoun, Lahoud Touma, Katie Luneau","doi":"10.1080/01658107.2026.2639108","DOIUrl":"10.1080/01658107.2026.2639108","url":null,"abstract":"Meningiomas are the most frequent primary intracranial tumors. Neuroimaging remains a pillar for the diagnosis and the clinical decisions that follow. Magnetic Resonance Imaging (MRI) has been the gold standard tool for evaluating meningiomas, alongside CT scans. However, many obstacles persist, hence the need for new technologies providing functional and molecular information on these tumors. This literature review aims to evaluate the role of 68Gallium DOTATATE PET scan in the diagnosis and management of meningiomas, specifically optic nerve sheath meningiomas (ONSM). Studies on this imaging technique found that the 68Ga-DOTATATE PET scan was more efficient than MRI in differentiating meningiomas from normal tissues, with a sensitivity of 90.1% compared to 79%. The scan was superior in distinguishing scar tissues from tumoral tissues and could detect a disease recurrence with a better sensitivity than the MRI. The addition of 68Ga-DOTATATE to the clinical management of meningiomas with neuro-ophthalmic implications turned out to be beneficial for the diagnosis, surgical planning, post-surgical radiation, and surveillance. This technology could allow to overcome certain limitations found with MRIs and CT scans, such as delineating tumor spread in anatomically challenging areas as well as attributing smaller and more precise radiation volumes.","PeriodicalId":19257,"journal":{"name":"Neuro-Ophthalmology","volume":"50 4","pages":"303-309"},"PeriodicalIF":0.6,"publicationDate":"2026-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13313225/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148352613","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Letter to the Editor: Comment on Gümüş et al.'s "Toluene-Related Toxic Optic Neuropathy: A Case Report". 致编辑的信：评论g<s:1> m<e:1>等人的“与甲苯相关的毒性视神经病变：一个病例报告”。

IF 0.6

Neuro-Ophthalmology Pub Date : 2026-05-21 eCollection Date: 2026-01-01 DOI: 10.1080/01658107.2026.2675330

Ali Mert Koçer, Atakan Acar

引用次数: 0

Variability Between Changes in Ocular Alignment and Gorman Diplopia Score After Teprotumumab in Thyroid Eye Disease. 甲状腺眼病患者Teprotumumab治疗后眼部排列和Gorman复视评分变化的可变性

IF 0.6

Neuro-Ophthalmology Pub Date : 2026-05-18 eCollection Date: 2026-01-01 DOI: 10.1080/01658107.2026.2673534

Madhura A Tamhankar, Taylor Linaburg, Miranda Meng, Kevin Zhang, Cory Shoshany, Clare W Teng, Yuanyuan Chen, César A Briceño, Tejus Pradeep

{"title":"Variability Between Changes in Ocular Alignment and Gorman Diplopia Score After Teprotumumab in Thyroid Eye Disease.","authors":"Madhura A Tamhankar, Taylor Linaburg, Miranda Meng, Kevin Zhang, Cory Shoshany, Clare W Teng, Yuanyuan Chen, César A Briceño, Tejus Pradeep","doi":"10.1080/01658107.2026.2673534","DOIUrl":"10.1080/01658107.2026.2673534","url":null,"abstract":"Diplopia in thyroid eye disease (TED) results from restrictive myopathy and can be disabling. Teprotumumab, an insulin-like growth factor-1 (IGF-1) antagonist, reduces proptosis and improves diplopia as measured by a subjective Gorman diplopia score without assessing ocular misalignment. This study evaluated whether there was observed variability between subjective versus objective measures of diplopia assessment in patients with TED treated with teprotumumab. This retrospective case series included patients with TED-related diplopia treated with teprotumumab at a single institution. Gorman diplopia scores and strabismus measurements in primary and cardinal gaze positions were recorded before and after treatment. Patients without diplopia, with unrelated strabismus, or with <3 months of post-treatment follow-up were excluded. The primary endpoint was change in ocular alignment and Gorman score before and after teprotumumab and the secondary endpoint was examining the difference between the two outcomes of diplopia assessment. Of 67 patients treated, 17 met inclusion criteria. Teprotumumab improved ocular alignment in 71% (12/17) and Gorman score in 59% (10/17). Changes in alignment and Gorman score were not in alignment in 41% (7/17): 12% (2/17) showed Gorman improvement despite worsened alignment, while 30% (5/17) had alignment improvement without change in Gorman score. Teprotumumab improves both ocular alignment and diplopia in most TED patients; however, differences were observed between subjective and objective outcome measures. Validated tools are needed to assess therapeutic outcomes more accurately in TED-related strabismus.","PeriodicalId":19257,"journal":{"name":"Neuro-Ophthalmology","volume":"50 5","pages":"466-471"},"PeriodicalIF":0.6,"publicationDate":"2026-05-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13540180/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148888121","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

A Comprehensive Narrative Review of Extracranial Vessel and Orbital MRI Findings in Giant Cell Arteritis. 巨细胞动脉炎颅内外血管及眼眶MRI表现的综合回顾。

IF 0.6

Neuro-Ophthalmology Pub Date : 2026-05-18 eCollection Date: 2026-01-01 DOI: 10.1080/01658107.2026.2667808

Terence Ang, Viraj Chaggar, Veda Muthineni, Sandy Patel, Sumu Simon, Dinesh Selva

{"title":"A Comprehensive Narrative Review of Extracranial Vessel and Orbital MRI Findings in Giant Cell Arteritis.","authors":"Terence Ang, Viraj Chaggar, Veda Muthineni, Sandy Patel, Sumu Simon, Dinesh Selva","doi":"10.1080/01658107.2026.2667808","DOIUrl":"10.1080/01658107.2026.2667808","url":null,"abstract":"A comprehensive narrative review of the superficial extracranial artery and orbital features on magnetic resonance imaging (MRI) in giant cell arteritis (GCA) is presented. A search on PubMed, EMBASE and Web of Science for English-language publications detailing MRI head/orbital imaging in GCA was conducted. Inclusion criteria were patients with positive histopathology and/or meeting the 2022 American college of Rheumatology (ACR) criteria who had MRI depicting significant abnormalities of the superficial extracranial vessels and/or orbit. 51 studies were identified for inclusion: 12 studies detailing analysis of superficial extracranial vessels, and 39 studies detailing orbital abnormalities. Articles included ranged from case-reports, retrospective case-series and prospective cohort studies, with variable patient-level data available for extraction and analysis. MRI of the extracranial arteries may demonstrate similar diagnostic power to that of ultrasound and demonstrates promising sensitivity and specificity when compared to biopsy-proven cases. The orbital features on MRI may occasionally be overlooked, however key structures include the intraconal orbital fat, optic nerve and nerve sheath and ophthalmic arteries. Subtle changes may exist in these clinically significant structures and represent important features which need to be identified to facilitate expedient diagnosis or guide further investigation and appropriate treatment. GCA should be a differential consideration in patients with non-specific intraconal fat inflammation and/or optic peri-neuritis, particularly if bilateral. Additionally, the concurrent presence of orbital inflammation (e.g.: optic peri-neuritis, intraconal orbital inflammation) and extracranial vessel wall inflammation should indicate a consideration of vasculitic pathology such as GCA.","PeriodicalId":19257,"journal":{"name":"Neuro-Ophthalmology","volume":"50 4","pages":"322-333"},"PeriodicalIF":0.6,"publicationDate":"2026-05-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13313251/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148352542","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

From Early Descriptions to Modern Imaging: The Evolving Understanding of Papilledema. 从早期描述到现代成像：对乳头状水肿的不断发展的理解。

IF 0.6

Neuro-Ophthalmology Pub Date : 2026-05-08 eCollection Date: 2026-01-01 DOI: 10.1080/01658107.2026.2670442

Gabriel Castilho Sandoval Barbosa, Mário Luiz Ribeiro Monteiro, Leonardo Provetti Cunha

{"title":"From Early Descriptions to Modern Imaging: The Evolving Understanding of Papilledema.","authors":"Gabriel Castilho Sandoval Barbosa, Mário Luiz Ribeiro Monteiro, Leonardo Provetti Cunha","doi":"10.1080/01658107.2026.2670442","DOIUrl":"10.1080/01658107.2026.2670442","url":null,"abstract":"Papilledema has long been recognised as a cardinal sign of elevated intracranial pressure, yet its structural underpinnings and dynamic behaviour have only recently become accessible through modern ocular imaging. This review traces the historical development of papilledema understanding, from early anatomical descriptions and the introduction of the ophthalmoscope to contemporary high-resolution imaging, and synthesises current evidence on the structural deformation of the optic nerve head in intracranial hypertension. Particular emphasis is placed on anterior displacement of the optic disc, a parameter that complements peripapillary retinal nerve fibre layer thickness assessment and offers unique insight into pressure-related biomechanics. We summarise key studies evaluating optic disc morphology across different aetiologies, treatment modalities, and time courses, highlighting the emergence of deformation of the optic nerve head patterns and their potential diagnostic and prognostic relevance. By integrating historical context, methodological advances, and contemporary evidence, this review outlines how structural imaging has reshaped current understanding and may further refine clinical assessment of papilledema.","PeriodicalId":19257,"journal":{"name":"Neuro-Ophthalmology","volume":"50 4","pages":"310-321"},"PeriodicalIF":0.6,"publicationDate":"2026-05-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13313247/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148352557","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Retinal Vascular Alterations in Chronic Non-Arteritic Anterior Ischemic Optic Neuropathy: A Dynamic Vessel Analyzer Study. 慢性非动脉性前缺血性视神经病变视网膜血管改变：动态血管分析仪研究。

IF 0.6

Neuro-Ophthalmology Pub Date : 2026-05-08 eCollection Date: 2026-01-01 DOI: 10.1080/01658107.2026.2670443

Ludovica Gargiulo, Gemma Tremolada, Alessandra Criscuoli, Diletta Santarsiero, Davide Soranna, Gabriella Cammarata, Lisa Melzi, Paola Ciasca, Paolo Milani, Carolina Lombardi, Stefania Bianchi Marzoli

{"title":"Retinal Vascular Alterations in Chronic Non-Arteritic Anterior Ischemic Optic Neuropathy: A Dynamic Vessel Analyzer Study.","authors":"Ludovica Gargiulo, Gemma Tremolada, Alessandra Criscuoli, Diletta Santarsiero, Davide Soranna, Gabriella Cammarata, Lisa Melzi, Paola Ciasca, Paolo Milani, Carolina Lombardi, Stefania Bianchi Marzoli","doi":"10.1080/01658107.2026.2670443","DOIUrl":"10.1080/01658107.2026.2670443","url":null,"abstract":"Non-arteritic anterior ischemic optic neuropathy (NAION) is a leading cause of sudden visual loss in older adults, often associated with vascular risk factors. The aim of this study was to investigate the retinal microvascular changes in chronic NAION and their relationship with systemic vascular conditions and obstructive sleep apnea (OSA). This retrospective observational study included 31 patients with chronic NAION (≥6 months from onset) and 17 age-matched healthy controls. Retinal microvascular parameters were assessed using the Dynamic Vessel Analyzer (DVA), including static and dynamic vessel metrics. Data were correlated with systemic vascular risk factors and polysomnographic findings. Arterial dilation amplitude was significantly reduced in eyes affected by chronic NAION compared to both contralateral unaffected eyes and healthy controls (p < .01). Static analysis revealed a significantly lower arteriovenous ratio (AVR) in both affected and unaffected eyes compared to controls. No significant differences were observed in venous parameters. Arterial diameter and dilation amplitude were positively correlated with ganglion cell layer thickness thickness and visual field sensitivity. OSA was diagnosed in 51% of patients, but no significant association was found between OSA and DVA parameters. In chronic NAION, DVA demonstrated impaired retinal arterial function, likely reflecting secondary effects of optic nerve damage. Retinal venous parameters remained unaffected. Cerebrovascular risk appeared more strongly associated with systemic vascular comorbidities than NAION itself. OSA, even in mild form, may contribute to disease severity.","PeriodicalId":19257,"journal":{"name":"Neuro-Ophthalmology","volume":"50 5","pages":"460-465"},"PeriodicalIF":0.6,"publicationDate":"2026-05-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13540127/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148888179","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Magnetic Resonance Imaging Findings in Children with Papilledema. 儿童乳头状水肿的磁共振成像表现。

IF 0.6

Neuro-Ophthalmology Pub Date : 2026-04-23 eCollection Date: 2026-01-01 DOI: 10.1080/01658107.2026.2657937

Elad Ziv-On, Niv Levy, Eliel Ben-David, Eilon Shcolnik, Elena Belyansky, Daniel Rappoport

{"title":"Magnetic Resonance Imaging Findings in Children with Papilledema.","authors":"Elad Ziv-On, Niv Levy, Eliel Ben-David, Eilon Shcolnik, Elena Belyansky, Daniel Rappoport","doi":"10.1080/01658107.2026.2657937","DOIUrl":"10.1080/01658107.2026.2657937","url":null,"abstract":"This retrospective cross-sectional study aimed to determine the prevalence and significance of MRI intracranial hypertension signs in children undergoing imaging for any clinical indication and investigate their correlation with papilledema findings. Data were analyzed from 160 children under 15 years who underwent both head MRI and ophthalmologic examination within a one-month interval at two tertiary medical centers in Israel over a two-year period. Ten established radiological markers associated with intracranial hypertension were evaluated by two specialized neuroradiologists, and ophthalmologic examinations were performed to assess for papilledema. Papilledema was confirmed in 19 patients (11.9%). Six MRI signs showed significant association with papilledema (p < .05), with optic nerve head protrusion demonstrating the highest odds ratio (OR = 30.2; 95% CI, 8.5-107.4; p < .001). Patients with papilledema had a significantly higher mean number of radiological signs than those without (3.1 vs 0.7, p < .001). The presence of at least one positive MRI sign increased papilledema odds (OR = 8.2), while more than three positive signs substantially elevated this risk (OR = 14.9). Both individual radiological markers and their cumulative presence significantly increase the likelihood of papilledema in children. Even when discovered incidentally, multiple MRI signs of intracranial hypertension warrant careful ophthalmological evaluation, as the presence of three or more radiological indicators is associated with nearly 15-fold increased odds of papilledema.","PeriodicalId":19257,"journal":{"name":"Neuro-Ophthalmology","volume":"50 5","pages":"451-459"},"PeriodicalIF":0.6,"publicationDate":"2026-04-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13540182/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148888173","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Longitudinal Microvascular Changes in Vascular Paralytic Strabismus: A Prospective Optical Coherence Tomography Angiography and Choroidal Vascularity Index Study. 血管麻痹性斜视的纵向微血管变化：一项前瞻性光学相干断层血管造影和脉络膜血管指数研究。

IF 0.6

Neuro-Ophthalmology Pub Date : 2026-04-10 eCollection Date: 2026-01-01 DOI: 10.1080/01658107.2026.2652283

Umay Güvenç, Fatma Gül Yılmaz Çınar, Yasemin Topalak, Evin Şingar

{"title":"Longitudinal Microvascular Changes in Vascular Paralytic Strabismus: A Prospective Optical Coherence Tomography Angiography and Choroidal Vascularity Index Study.","authors":"Umay Güvenç, Fatma Gül Yılmaz Çınar, Yasemin Topalak, Evin Şingar","doi":"10.1080/01658107.2026.2652283","DOIUrl":"10.1080/01658107.2026.2652283","url":null,"abstract":"To evaluate dynamic intraocular microvascular changes in vascular paralytic strabismus using optical coherence tomography angiography (OCTA) and choroidal vascularity index (CVI), and to assess their reversibility after clinical recovery. In this prospective study, 31 patients with acute-onset vascular paralytic strabismus involving the third, fourth, or sixth cranial nerve were enrolled. OCTA and enhanced depth imaging (EDI)-OCT were performed during the paralytic phase and after full recovery. Parameters included vessel density (VD) in the superficial (SCP) and deep capillary plexuses (DCP), foveal avascular zone (FAZ), choriocapillaris flow, CVI and peripapillary vessel density (ppVD). Inter-eye and inter-phase differences were analysed. Statistical analysis was performed using generalised estimating equations (GEE) to account for within-subject correlations between eyes. During the paralysis phase, the affected eyes showed significantly reduced VD in the SCP across all macular regions, while changes in the DCP were limited to the fovea (p < .001). The FAZ area was larger (p = .012), and CVI was lower (p < .001) in the affected eye. After clinical recovery, SCP VD, choriocapillaris flow, and CVI in the previously affected eyes increased significantly, while FAZ and non-flow area decreased (p < .001 for both). Intradisc ppVD also improved (p = .048). Retinal and choroidal thickness remained stable. Vascular paralytic strabismus causes reversible ischaemic alterations, primarily in the macular SCP and choroid. These findings support a functional vascular disturbance rather than structural damage. This is the first study to evaluate the CVI in this condition, highlighting the utility of OCTA and EDI-OCT as noninvasive tools for monitoring dynamic ocular perfusion alterations.","PeriodicalId":19257,"journal":{"name":"Neuro-Ophthalmology","volume":"50 5","pages":"416-429"},"PeriodicalIF":0.6,"publicationDate":"2026-04-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13540113/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148888107","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0