Evaluating ocular torsion following inferior oblique weakening in superior oblique palsy: a pilot study using color fundus photography and spectral domain optical coherence tomography

Abstract Purpose To compare spectral domain optical coherence tomography (OCT) and color fundus photography (CFP) for assessing ocular cyclotorsion in unilateral congenital superior oblique palsy (SOP) before and after inferior oblique disinsertion. Methods This prospective pilot study evaluated 18...

Full description

Saved in:
Bibliographic Details
Main Authors: Kaveh Abri Aghdam, Afsane Katiraee, Samira Chaibakhsh, Mostafa Soltan Sanjari, Arezoo Miraftabi, Fateme Nadjafi, Ali Sadeghi, Vahid Zare Hosseinabadi, Amin Zand
Format: Article
Language:English
Published: BMC 2025-07-01
Series:BMC Ophthalmology
Subjects:
Online Access:https://doi.org/10.1186/s12886-025-04205-6
Tags: Add Tag
No Tags, Be the first to tag this record!
_version_ 1849238656215154688
author Kaveh Abri Aghdam
Afsane Katiraee
Samira Chaibakhsh
Mostafa Soltan Sanjari
Arezoo Miraftabi
Fateme Nadjafi
Ali Sadeghi
Vahid Zare Hosseinabadi
Amin Zand
author_facet Kaveh Abri Aghdam
Afsane Katiraee
Samira Chaibakhsh
Mostafa Soltan Sanjari
Arezoo Miraftabi
Fateme Nadjafi
Ali Sadeghi
Vahid Zare Hosseinabadi
Amin Zand
author_sort Kaveh Abri Aghdam
collection DOAJ
description Abstract Purpose To compare spectral domain optical coherence tomography (OCT) and color fundus photography (CFP) for assessing ocular cyclotorsion in unilateral congenital superior oblique palsy (SOP) before and after inferior oblique disinsertion. Methods This prospective pilot study evaluated 18 patients (36 eyes) with unilateral congenital SOP. Disc-foveal angle (DFA) was measured preoperatively and 3 months postoperatively using CFP (analyzed with ImageJ) and Spectralis OCT (with FoDi software). Contralateral nonparetic eyes served as controls. Results Preoperative hypertropia (14.31 ± 4.15 prism diopter, PD) significantly improved postoperatively (1.46 ± 1.98 PD, P < 0.001). CFP measurements showed significantly greater cyclotorsion in paretic versus nonparetic eyes preoperatively (P = 0.001), while OCT revealed no inter-eye difference (P = 0.295). In paretic eyes, CFP-derived DFAs were significantly higher than OCT values both preoperatively (12.26 ± 4.72° vs. 8.87 ± 4.56°, P = 0.002) and postoperatively (7.25 ± 5.18° vs. 4.33 ± 3.98°, P = 0.005). Nonparetic eyes showed no significant inter-method differences at either timepoint (all P > 0.05). Inter-method reliability was moderate preoperatively (ICC = 0.693 paretic, 0.657 nonparetic) and improved postoperatively (ICC = 0.718 and 0.921, respectively). Bland-Altman analysis demonstrated narrowing limits of agreement postoperatively (nonparetic: 8.48° to 4.40°; paretic: 7.97° to 7.50°), with no systematic bias. Conclusion Spectralis OCT with FoDi software provides a clinically useful alternative to CFP for cyclotorsion assessment in congenital SOP, though it may systematically underestimate DFA values in paretic eyes.
format Article
id doaj-art-e5e35efb3c964f4d9efc0dbd154e604a
institution Kabale University
issn 1471-2415
language English
publishDate 2025-07-01
publisher BMC
record_format Article
series BMC Ophthalmology
spelling doaj-art-e5e35efb3c964f4d9efc0dbd154e604a2025-08-20T04:01:26ZengBMCBMC Ophthalmology1471-24152025-07-012511810.1186/s12886-025-04205-6Evaluating ocular torsion following inferior oblique weakening in superior oblique palsy: a pilot study using color fundus photography and spectral domain optical coherence tomographyKaveh Abri Aghdam0Afsane Katiraee1Samira Chaibakhsh2Mostafa Soltan Sanjari3Arezoo Miraftabi4Fateme Nadjafi5Ali Sadeghi6Vahid Zare Hosseinabadi7Amin Zand8Eye Research Center, Ophthalmology Department, Rassoul Akram Hospital, School of Medicine, The Five Senses Health Institute, Iran University of Medical SciencesEye Research Center, Ophthalmology Department, Rassoul Akram Hospital, School of Medicine, The Five Senses Health Institute, Iran University of Medical SciencesEye Research Center, Ophthalmology Department, Rassoul Akram Hospital, School of Medicine, The Five Senses Health Institute, Iran University of Medical SciencesEye Research Center, Ophthalmology Department, Rassoul Akram Hospital, School of Medicine, The Five Senses Health Institute, Iran University of Medical SciencesEye Research Center, Ophthalmology Department, Rassoul Akram Hospital, School of Medicine, The Five Senses Health Institute, Iran University of Medical SciencesEye Research Center, Ophthalmology Department, Rassoul Akram Hospital, School of Medicine, The Five Senses Health Institute, Iran University of Medical SciencesEye Research Center, Ophthalmology Department, Rassoul Akram Hospital, School of Medicine, The Five Senses Health Institute, Iran University of Medical SciencesEye Research Center, Ophthalmology Department, Rassoul Akram Hospital, School of Medicine, The Five Senses Health Institute, Iran University of Medical SciencesClinical Research Development Unit, Shafa Hospital, Kerman University of Medical SciencesAbstract Purpose To compare spectral domain optical coherence tomography (OCT) and color fundus photography (CFP) for assessing ocular cyclotorsion in unilateral congenital superior oblique palsy (SOP) before and after inferior oblique disinsertion. Methods This prospective pilot study evaluated 18 patients (36 eyes) with unilateral congenital SOP. Disc-foveal angle (DFA) was measured preoperatively and 3 months postoperatively using CFP (analyzed with ImageJ) and Spectralis OCT (with FoDi software). Contralateral nonparetic eyes served as controls. Results Preoperative hypertropia (14.31 ± 4.15 prism diopter, PD) significantly improved postoperatively (1.46 ± 1.98 PD, P < 0.001). CFP measurements showed significantly greater cyclotorsion in paretic versus nonparetic eyes preoperatively (P = 0.001), while OCT revealed no inter-eye difference (P = 0.295). In paretic eyes, CFP-derived DFAs were significantly higher than OCT values both preoperatively (12.26 ± 4.72° vs. 8.87 ± 4.56°, P = 0.002) and postoperatively (7.25 ± 5.18° vs. 4.33 ± 3.98°, P = 0.005). Nonparetic eyes showed no significant inter-method differences at either timepoint (all P > 0.05). Inter-method reliability was moderate preoperatively (ICC = 0.693 paretic, 0.657 nonparetic) and improved postoperatively (ICC = 0.718 and 0.921, respectively). Bland-Altman analysis demonstrated narrowing limits of agreement postoperatively (nonparetic: 8.48° to 4.40°; paretic: 7.97° to 7.50°), with no systematic bias. Conclusion Spectralis OCT with FoDi software provides a clinically useful alternative to CFP for cyclotorsion assessment in congenital SOP, though it may systematically underestimate DFA values in paretic eyes.https://doi.org/10.1186/s12886-025-04205-6Disc-foveal angleFundus photographyInferior oblique weakeningOcular torsionSpectralis OCTCongenital superior oblique palsy
spellingShingle Kaveh Abri Aghdam
Afsane Katiraee
Samira Chaibakhsh
Mostafa Soltan Sanjari
Arezoo Miraftabi
Fateme Nadjafi
Ali Sadeghi
Vahid Zare Hosseinabadi
Amin Zand
Evaluating ocular torsion following inferior oblique weakening in superior oblique palsy: a pilot study using color fundus photography and spectral domain optical coherence tomography
BMC Ophthalmology
Disc-foveal angle
Fundus photography
Inferior oblique weakening
Ocular torsion
Spectralis OCT
Congenital superior oblique palsy
title Evaluating ocular torsion following inferior oblique weakening in superior oblique palsy: a pilot study using color fundus photography and spectral domain optical coherence tomography
title_full Evaluating ocular torsion following inferior oblique weakening in superior oblique palsy: a pilot study using color fundus photography and spectral domain optical coherence tomography
title_fullStr Evaluating ocular torsion following inferior oblique weakening in superior oblique palsy: a pilot study using color fundus photography and spectral domain optical coherence tomography
title_full_unstemmed Evaluating ocular torsion following inferior oblique weakening in superior oblique palsy: a pilot study using color fundus photography and spectral domain optical coherence tomography
title_short Evaluating ocular torsion following inferior oblique weakening in superior oblique palsy: a pilot study using color fundus photography and spectral domain optical coherence tomography
title_sort evaluating ocular torsion following inferior oblique weakening in superior oblique palsy a pilot study using color fundus photography and spectral domain optical coherence tomography
topic Disc-foveal angle
Fundus photography
Inferior oblique weakening
Ocular torsion
Spectralis OCT
Congenital superior oblique palsy
url https://doi.org/10.1186/s12886-025-04205-6
work_keys_str_mv AT kavehabriaghdam evaluatingoculartorsionfollowinginferiorobliqueweakeninginsuperiorobliquepalsyapilotstudyusingcolorfundusphotographyandspectraldomainopticalcoherencetomography
AT afsanekatiraee evaluatingoculartorsionfollowinginferiorobliqueweakeninginsuperiorobliquepalsyapilotstudyusingcolorfundusphotographyandspectraldomainopticalcoherencetomography
AT samirachaibakhsh evaluatingoculartorsionfollowinginferiorobliqueweakeninginsuperiorobliquepalsyapilotstudyusingcolorfundusphotographyandspectraldomainopticalcoherencetomography
AT mostafasoltansanjari evaluatingoculartorsionfollowinginferiorobliqueweakeninginsuperiorobliquepalsyapilotstudyusingcolorfundusphotographyandspectraldomainopticalcoherencetomography
AT arezoomiraftabi evaluatingoculartorsionfollowinginferiorobliqueweakeninginsuperiorobliquepalsyapilotstudyusingcolorfundusphotographyandspectraldomainopticalcoherencetomography
AT fatemenadjafi evaluatingoculartorsionfollowinginferiorobliqueweakeninginsuperiorobliquepalsyapilotstudyusingcolorfundusphotographyandspectraldomainopticalcoherencetomography
AT alisadeghi evaluatingoculartorsionfollowinginferiorobliqueweakeninginsuperiorobliquepalsyapilotstudyusingcolorfundusphotographyandspectraldomainopticalcoherencetomography
AT vahidzarehosseinabadi evaluatingoculartorsionfollowinginferiorobliqueweakeninginsuperiorobliquepalsyapilotstudyusingcolorfundusphotographyandspectraldomainopticalcoherencetomography
AT aminzand evaluatingoculartorsionfollowinginferiorobliqueweakeninginsuperiorobliquepalsyapilotstudyusingcolorfundusphotographyandspectraldomainopticalcoherencetomography