Evaluation of Retinal and Choroidal Microvascularity in Patients with Benign Essential Blepharospasm

Purpose: To assess the retinal and choroidal microvascular changes in patients with benign essential blepharospasm (BEB) and to investigate the factors that may be effective on microvascularity. Methods: This study included patients with BEB and healthy controls. All participants underwent a comprehensive examination followed by optical coherence tomography angiography (OCTA). Macular vascular perfusion density (VPD), foveal avascular zone (FAZ), and subfoveal choroidal thickness (CT) were measured. The clinical findings of the BEB group and the administration of botulinum toxin A (BTx-A) prior to OCTA imaging were recorded retrospectively from the medical records. Results: A total of 16 patients with BEB and 20 healthy controls were included in this study. VPD values in all quadrants of the superficial and deep macular capillary plexus were significantly different in the BEB group compared to the control group (each p-value <0.05). In the choriocapillaris layer, VPD was significantly higher in the superior, nasal, and temporal quadrants compared to the control group (each p-value <0.05). The BEB group exhibited significantly smaller superficial and deep FAZ values compared to the control group, consistent with the observed increase in vascular density (each p-value <0.05). CT was thinner in the BEB group, although not statistically significant (p = 0.138). No correlation was found between the total dose of BTx-A administered to the BEB group and OCTA parameters (each p-value >0.05) Conclusion: Benign essential blepharospasm may be associated with increased retinal vascular density in the superficial and deep capillary plexus and decreased FAZ area.