Abstract
Establishing the reliability of a new method to check the mean retinal and choroidal reflectivity and using it to find retinal and choroid changes in amblyopia. Design: Retrospective case-control. Population: 28 subjects of which 10 were healthy controls (20 eyes): 8 with refractive errors, 1 with strabismus, and 1 with both. 18 patients with unilateral amblyopia included: 7 anisometropic, 6 isoametropic, 1 strabismic, and 4 combined. Mean participants' age: 13.77 years ± 10.28. Observation procedures: SD-OCT and ImageJ. Main outcome measure: mean reflectivity of retinal and choroid layers. Amblyopic, fellow, and healthy eyes were compared. The method of measuring reflectivity is good to excellent reliability for all regions of interest except the fourth. The mean reflectivity of the choriocapillaris and Sattler's layer in amblyopic eyes were significantly lower than in healthy eyes (p = 0.003 and p = 0.008 respectively). The RNFL reflectivity was lower than that of fellow eyes (p = 0.025). Post-hoc pairwise comparisons showed statistically significant differences between amblyopic and healthy eyes for choriocapillaris (p = 0.018) and Sattler's (p = 0.035), and between amblyopic and fellow eyes for RNFL (p = 0.039). A decrease in reflectivity of the choriocapillaris and Sattler's in amblyopic compared to healthy eyes, and a decrease in reflectivity of the RNFL in the amblyopic compared to fellow eyes, indicate that the pathophysiology is partly peripheral and might be bilateral.
Highlights
Amblyopia is one of the most important causes of pediatric vision impairment
The method of measuring reflectivity is good to excellent reliability for all regions of interest except the fourth
A decrease in reflectivity of the choriocapillaris and Sattler’s in amblyopic compared to healthy eyes, and a decrease in reflectivity of the retinal nerve fiber layer (RNFL) in the amblyopic compared to fellow eyes, indicate that the pathophysiology is partly peripheral and might be bilateral
Summary
The estimated prevalence of amblyopia is 2–4% in the general population [1]. Height, gender, ethnicity, and socioeconomic status do not affect the occurrence of amblyopia [2]. Defined as a disease with no organic findings [1], many studies have detected changes affecting the retina [3,4,5,6,7,8], lateral geniculate nucleus [9, 10], and the visual cortex [9, 11]. Whether the pathological mechanism originates in the retina, primary cortex, or higher centers remains a matter of controversy [11], as well as whether amblyopia is a monocular or binocular condition [1, 12]
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