Journal of Clinical Medicine

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Ocular Microcirculation and Clinical Outcomes in Ophthalmic Diseases

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Prof. Dr. Robert Rejdak

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Guest Editor

Department of General and Pediatric Ophthalmology, Medical University of Lublin, 20-079 Lublin, Poland
Interests: cataract surgery; retinal diseases; retinal degeneration; retinal imaging; vitreoretinal surgery; intravitreal injections; OCT

Dr. Małgorzata Latalska

E-Mail Website
Guest Editor Assistant

Department of General and Pediatric Ophthalmology, Medical University of Lublin, Lublin, Poland
Interests: ophthalmology; retinal diseases; age-related macular degeneration (AMD); diabetic retinopathy; laser photocoagulation; fluorescein angiography (FA); choroidal pathologies; optic nerve diseases; vascular disorders; nailfold videocapillaroscopy (NVC); plant

Special Issue Information

Dear Colleagues,

The Special Issue “Ocular Microcirculation and Clinical Outcomes in Ophthalmic Diseases” aims to explore the role of ocular microcirculation in various ophthalmic conditions and its impact on clinical outcomes. Ocular microcirculation, including the intraocular vasculature and microvascular systems, plays a crucial role in the health of the retina, optic nerve, and the entire ocular structure. Advances in medical imaging, molecular biology, and hemodynamics have shed new light on the study of ocular microcirculation, particularly in the early diagnosis, treatment, and prognosis of diseases such as diabetic retinopathy, glaucoma, optic neuropathy, and macular degeneration. This Special Issue will compile the latest clinical and basic research findings to promote the understanding and clinical application of ocular microcirculation, offering scientific evidence for precision diagnosis and treatment in ophthalmology.

Prof. Dr. Robert Rejdak
Guest Editor

Dr. Małgorzata Latalska
Guest Editor Assistant

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10 pages, 468 KB

Open AccessArticle

Retinal and Choroidal Microvascular Alterations Associated with Compensatory Head Tilt in Congenital Superior Oblique Palsy: An Interocular OCTA Analysis

by Osman Parca, Tunahan Akyol, Emine Seker Un and Beyzanur Yıldız

J. Clin. Med. 2026, 15(13), 4906; https://doi.org/10.3390/jcm15134906 - 24 Jun 2026

Viewed by 293

Abstract

Background/Objectives: To evaluate interocular retinal and choroidal microvascular alterations associated with compensatory head tilt in unilateral congenital superior oblique palsy (SOP) and to investigate their relationship with head tilt degree using optical coherence tomography angiography (OCTA). Methods: This retrospective cross-sectional study included 34 patients with congenital SOP and head tilt–dominant abnormal head posture. A paired-eye design compared the tilt-side eye with the opposite-side eye. Superficial and deep capillary plexus (SCP, DCP) vessel density, foveal avascular zone (FAZ) parameters, choroidal vascularity index (CVI), and subfoveal choroidal thickness (SFCT) were assessed. Interocular differences were defined as Δ = opposite-side eye − tilt-side eye. Correlation and multivariable regression analyses were performed to assess associations with head tilt degree. The interocular difference in CVI (ΔCVI) and its association with head tilt degree were defined as the primary outcomes, whereas retinal OCTA parameters, FAZ metrics, and SFCT were considered exploratory secondary outcomes. Results: CVI showed the most prominent interocular difference, being higher in the opposite-side eye than in the tilt-side eye (0.71 ± 0.04 vs. 0.68 ± 0.04; p < 0.001), whereas SFCT did not differ significantly (p = 0.395). SCP foveal vessel density and DCP inferior vessel density showed nominal differences in the unadjusted analyses but did not remain statistically significant after Benjamini–Hochberg false discovery rate correction. ΔCVI correlated positively with head tilt degree (ρ = +0.533, p = 0.001) and remained independently associated in multivariable analysis (p = 0.001). Conclusions: Compensatory head tilt in congenital SOP is associated with measurable interocular microvascular asymmetry, predominantly at the choroidal level. CVI demonstrated the strongest association with head tilt severity, whereas retinal OCTA findings were exploratory, suggesting that OCTA may provide objective insight into posture-related choroidal microvascular alterations. Full article

(This article belongs to the Special Issue Ocular Microcirculation and Clinical Outcomes in Ophthalmic Diseases)

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