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...
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BMC
2025-07-01
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| Series: | BMC Ophthalmology |
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| Online Access: | https://doi.org/10.1186/s12886-025-04205-6 |
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| 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 |
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| 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 |
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