Tonsillectomy and/or adenoidectomy improves macular microcirculation in children with obstructive sleep apnea

Abstract This study aims to observe the changes in macular microcirculation before and after tonsil and/or adenoid surgery in children diagnosed with obstructive sleep apnea (OSA). Pediatric patients with OSA who underwent tonsillectomy and/or adenoidectomy at the Department of Otorhinolaryngology,...

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Main Authors: Zhen Xue, Bangtao Yao, Yao Yang, Li Yin
Format: Article
Language:English
Published: Nature Portfolio 2025-08-01
Series:Scientific Reports
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Online Access:https://doi.org/10.1038/s41598-025-16476-6
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author Zhen Xue
Bangtao Yao
Yao Yang
Li Yin
author_facet Zhen Xue
Bangtao Yao
Yao Yang
Li Yin
author_sort Zhen Xue
collection DOAJ
description Abstract This study aims to observe the changes in macular microcirculation before and after tonsil and/or adenoid surgery in children diagnosed with obstructive sleep apnea (OSA). Pediatric patients with OSA who underwent tonsillectomy and/or adenoidectomy at the Department of Otorhinolaryngology, the Affiliated Jiangning Hospital with Nanjing Medical University, from July 2019 to December 2023, were included in the OSA group (n = 100). A control group consisting of normal children who underwent physical examinations at the ophthalmology clinic was also selected (n = 50). OSA-18 scale, and optical coherence tomography angiography (OCTA) were conducted. The study focused on the changes in the superficial capillary plexus (SCP), including vascular length density (VLD), vascular perfusion density (VPD), and the foveal avascular zone (FAZ) within the central concave region of the macula. (1) VLD1, VLD2, VPD1, and VPD2 exhibited significantly lower values in the macular area of children in the OSA group compared to the control group (P < 0.05). In contrast, VLD3, VLD4, VPD3, VPD4, and FAZ did not show statistically significant differences between the two groups (P > 0.05). (2) Postoperative OSA-18 scores in children with OSA were significantly lower than preoperative scores (P < 0.05). Additionally, postoperative VLD1, VLD2, VPD1, and VPD2 were significantly elevated in children with OSA (P < 0.05), while no statistically significant differences were observed for the remaining indices before and after surgery (P > 0.05). (3) There were no statistically significant differences across all indices between the OSA group at 6 months postoperatively and the control group (P > 0.05). Tonsillectomy and/or adenoidectomy may enhance macular microcirculation, potentially aiding in the prevention of fundus complications. OCTA could serve as a supplementary tool for the early assessment of surgical indications in pediatric cases of OSA.
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spelling doaj-art-a767cda30ed64e08a3826fad2f1550c32025-08-24T11:23:14ZengNature PortfolioScientific Reports2045-23222025-08-011511810.1038/s41598-025-16476-6Tonsillectomy and/or adenoidectomy improves macular microcirculation in children with obstructive sleep apneaZhen Xue0Bangtao Yao1Yao Yang2Li Yin3Department of Otolaryngology, Nanjing Lishui People’s Hospital, Zhongda Hospital Lishui branch, Southeast UniversityDepartment of Ophthalmology, Nanjing Lishui People’s Hospital, Zhongda Hospital Lishui branch, Southeast UniversityDepartment of Otolaryngology, Head and Neck Surgery, The Affiliated Jiangning Hospital of Nanjing Medical UniversityDepartment of Ophthalmology, The Affiliated Jiangning Hospital of Nanjing Medical UniversityAbstract This study aims to observe the changes in macular microcirculation before and after tonsil and/or adenoid surgery in children diagnosed with obstructive sleep apnea (OSA). Pediatric patients with OSA who underwent tonsillectomy and/or adenoidectomy at the Department of Otorhinolaryngology, the Affiliated Jiangning Hospital with Nanjing Medical University, from July 2019 to December 2023, were included in the OSA group (n = 100). A control group consisting of normal children who underwent physical examinations at the ophthalmology clinic was also selected (n = 50). OSA-18 scale, and optical coherence tomography angiography (OCTA) were conducted. The study focused on the changes in the superficial capillary plexus (SCP), including vascular length density (VLD), vascular perfusion density (VPD), and the foveal avascular zone (FAZ) within the central concave region of the macula. (1) VLD1, VLD2, VPD1, and VPD2 exhibited significantly lower values in the macular area of children in the OSA group compared to the control group (P < 0.05). In contrast, VLD3, VLD4, VPD3, VPD4, and FAZ did not show statistically significant differences between the two groups (P > 0.05). (2) Postoperative OSA-18 scores in children with OSA were significantly lower than preoperative scores (P < 0.05). Additionally, postoperative VLD1, VLD2, VPD1, and VPD2 were significantly elevated in children with OSA (P < 0.05), while no statistically significant differences were observed for the remaining indices before and after surgery (P > 0.05). (3) There were no statistically significant differences across all indices between the OSA group at 6 months postoperatively and the control group (P > 0.05). Tonsillectomy and/or adenoidectomy may enhance macular microcirculation, potentially aiding in the prevention of fundus complications. OCTA could serve as a supplementary tool for the early assessment of surgical indications in pediatric cases of OSA.https://doi.org/10.1038/s41598-025-16476-6Adenotonsillectomy (AT)Obstructive sleep apnea (OSA)PediatricOptical coherence tomography angiography (OCTA)Macular blood flow
spellingShingle Zhen Xue
Bangtao Yao
Yao Yang
Li Yin
Tonsillectomy and/or adenoidectomy improves macular microcirculation in children with obstructive sleep apnea
Scientific Reports
Adenotonsillectomy (AT)
Obstructive sleep apnea (OSA)
Pediatric
Optical coherence tomography angiography (OCTA)
Macular blood flow
title Tonsillectomy and/or adenoidectomy improves macular microcirculation in children with obstructive sleep apnea
title_full Tonsillectomy and/or adenoidectomy improves macular microcirculation in children with obstructive sleep apnea
title_fullStr Tonsillectomy and/or adenoidectomy improves macular microcirculation in children with obstructive sleep apnea
title_full_unstemmed Tonsillectomy and/or adenoidectomy improves macular microcirculation in children with obstructive sleep apnea
title_short Tonsillectomy and/or adenoidectomy improves macular microcirculation in children with obstructive sleep apnea
title_sort tonsillectomy and or adenoidectomy improves macular microcirculation in children with obstructive sleep apnea
topic Adenotonsillectomy (AT)
Obstructive sleep apnea (OSA)
Pediatric
Optical coherence tomography angiography (OCTA)
Macular blood flow
url https://doi.org/10.1038/s41598-025-16476-6
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AT bangtaoyao tonsillectomyandoradenoidectomyimprovesmacularmicrocirculationinchildrenwithobstructivesleepapnea
AT yaoyang tonsillectomyandoradenoidectomyimprovesmacularmicrocirculationinchildrenwithobstructivesleepapnea
AT liyin tonsillectomyandoradenoidectomyimprovesmacularmicrocirculationinchildrenwithobstructivesleepapnea