Strengths and limitations
large-angle, NCS, strabismus, exodeviation
EXODEVIATION, STRABISMUS, EXOTROPIA, ALTERNATION, PATHOGENESIS
To the best of our knowledge, this was the first study to investigate RT and macular microvasculature in patients with large-angle deviation whose binocular vision was abnormal in comparison with healthy controls based on OCTA. In addition, we analysed nine zones of macular values from the perspective of the deviated eye and the dominant eye. More importantly, we investigated the difference between the deviated eye and the contralateral eye in large-angle exotropia to explore the retinal morphological alternation and the possible pathogenesis of strabismus. In addition, we set a more stringent p-value of less than 0.01 to reduce the bias of comparisons.It should be noted that our study had some limitations. First and foremost, a relevant small sample size was included in the analysis, which may introduce a little bias. The comparisons for various metrics inevitably caused statistical error. Therefore, we established standard inclusion and exclusion criteria to avoid possible errors, such as excluding those with poor control (NCS ≥ 4) and considering a significant p-value less than 0.01. Then, all subjects had a large exodeviation and required strabismus surgery, whether the remaining binocular vision alters the results is still unclear. In addition, patients with concomitant strabismus may not be attentive to the blue spot in OCTA imaging. Due to the limited economic condition of the hospital, we could not provide an ultra-widefield fluorescein angiography image. The 6*6-mm scan of the macular area may also be sufficient for basic identification. This may be one of the reasons for data bias. Further studies with a larger sample size are needed, including the evaluation of the macular vasculature and binocular vision to provide identical guidance for clinical diagnosis.