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Interocular differences in retinal microvascular parameters in unilateral Duane retraction syndrome: A paired-eye
Tugce Horozoglu Ceran1, Pinar Bingol Kiziltunc2, Huseyin Kayabas1
1Department of Ophthalmology, Faculty of Medicine, Afyonkarahisar Health Sciences University, Afyonkarahisar, Türkiye.
Purpose:
To evaluate interocular differences in retinal microvascular parameters, including macular and peripapillary measurements, in unilateral Duane retraction syndrome (DRS) using optical coherence tomography angiography (OCTA), with the clinically unaffected fellow eye as a within-subject comparator.
Methods:
This multicenter, cross-sectional paired-eye study included 19 patients with unilateral DRS. Macular superficial capillary plexus (SCP) and deep capillary plexus (DCP) vessel density (VD), foveal avascular zone metrics, outer retinal and choriocapillaris flow parameters, axial length, retinal nerve fiber layer (RNFL) thickness, and optic disc/peripapillary OCTA measurements were compared between affected and fellow eyes. Outcome-specific complete-pair analyses were performed, and Benjamini-Hochberg false discovery rate (FDR) correction was applied across 28 prespecified interocular comparisons.
Results:
Mean (SD) age was 14.9 (9.8) years, and 11 patients (57.9%) were female. After FDR correction, affected eyes showed lower SCP VD in the whole-image (mean paired difference, -2.59 percentage points; adjusted P = 0.032) and foveal (-4.07 percentage points; adjusted P = 0.012) regions and lower DCP VD in the whole-image (-4.74 percentage points; adjusted P = 0.020) and foveal (-3.93 percentage points; adjusted P = 0.049) regions. Parafoveal DCP VD was also lower in affected eyes (median paired difference, -4.50 percentage points; adjusted P = 0.021). No statistically significant interocular differences were detected in axial length, foveal avascular zone metrics, outer retinal or choriocapillaris flow, RNFL thickness, or optic disc/peripapillary VD.
Conclusions:
Unilateral DRS was associated with regional interocular differences in OCTA-derived macular VD, without evidence of similarly detectable differences in peripapillary microvasculature or RNFL thickness. These exploratory findings do not establish retinal microvascular impairment and require confirmation in larger studies incorporating healthy controls, quantitative image-quality assessment, fixation analysis, and longitudinal follow-up.
