OCT-Angiography Findings in Patients with Amblyopia: Comparison between Healthy Controls, Treatment-Responsive, and Treatment-Unresponsive Amblyopic Patients.

Annabella Salerni,Clara Rizzo,Umberto De Vico,Ludovica Paris,Daniela Bacherini,Gloria Gambini,Emanuele Crincoli,Chiara Fedeli,Raphael Killian,Stanislao Rizzo,Maria Cristina Savastano,Gustavo Savino

doi:10.3390/diagnostics11101751

Abstract

There is no consensus on whether amblyopia affects the retinal vascular plexus and morphology. Previous studies focused on the differences between amblyopic patients and normal controls without evaluating amblyopic eyes after patching. To evaluate differences in the superficial vascular density of amblyopic eyes, normal eyes, and amblyopic eyes reaching normal BCVA after patch therapy, OCTA was used. All patients underwent a comprehensive ophthalmological examination, including visual acuity, refraction, ocular motility tests, and anterior and posterior segment examination. OCTA was performed by an expert physician using the Zeiss Cirrus 5000-HD-OCT Angioplex (Carl Zeiss, Meditec, Inc., Dublin, OH, USA). OCTA scans were performed using a 3 × 3 mm2 and 6 × 6 mm2 fovea-centered image setting. The mean outer macular vessel density in the previously amblyopic group was 19.15 ± 0.51%. This was statistically significantly higher than in both the amblyopic group (18.70 ± 1.14%) and the normal controls (18.18 ± 1.40%) (p = 0.014). The previously amblyopic group also significantly differed from both normal controls and amblyopic eyes with regards to the inner (p = 0.011), outer (p = 0.006), and full (p = 0.003) macular perfusion. Finally, linear regression analysis revealed that BCVA was linearly correlated to outer perfusion in amblyopic (p = 0.003) and ex amblyopic eyes (p < 0.001). Considering the cross-sectional nature of our study, from our results, we can only hypothesize a possible correlation between light stimulation and retinal vasculature development. However, further longitudinal studies are needed to support this hypothesis.

Highlights

Amblyopia is the most common cause of monocular and binocular vision loss in children and its population-based prevalence ranges from 0.5% to 3.5% [1,2,3,4]
The previously amblyopic group significantly differed from both normal controls and amblyopic eyes with regards to the inner (p = 0.011), outer (p = 0.006), and full (p = 0.003) macular perfusion
A statistically significant difference in full macular vessel density was noted between previously amblyopic eyes and normal controls (p = 0.042) (Table 1, Figure 2)

Summary

Introduction

Amblyopia is the most common cause of monocular and binocular vision loss in children and its population-based prevalence ranges from 0.5% to 3.5% [1,2,3,4]. Amblyopia is traditionally considered a cortical disease. The involvement of other structures in the visual pathway related to this disease is still to be determined [5,6]. Microscopic and functional abnormalities have been reported in the lateral geniculate nucleus, but the involvement of the retina is still debated [7,8,9]. With the advances in optical coherence tomography (OCT), several studies have shown structural abnormalities or modifications in the retina, the optic nerve, and the choroid of amblyopic eyes, compared to normal controls [10,11,12,13,14,15]. The results are often contradictory due to different confounding factors

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