Spectral-domain optical coherence tomography analysis in deprivational amblyopia: a pilot study with unilateral pediatric cataract patients

Abstract

To investigate whether macular and peripapillary retinal nerve fiber layer (RNFL) structure differs among deprivational amblyopic eyes, fellow non-amblyopic eyes, and age-matched normal eyes, using spectral-domain optical coherence tomography (SD-OCT). Macula and optic disc of 14 unilateral pseudophakic children with deprivational amblyopia, and 14 age-matched normal children (mean age, 7.45 ± 2.57 years) were scanned with Cirrus(TM) HD-OCT. Macular, RNFL, and macular ganglion cell-inner plexiform layer (GCIPL) thicknesses were measured, and compared between the eyes after correction for axial length-related magnification errors. The average RNFL thickness tended to be greater in amblyopic eyes (99.64 ± 10.11 μm) than in fellow non-amblyopic eyes (97.28 ± 12.34 μm) and normal eyes (95.38 ± 9.74 μm), but did not show statistical significance (p = 0.429, p = 0.286 respectively). The nasal RNFL thickness was significantly greater in amblyopic eyes (75.84 ± 19.22 μm) than in fellow non-amblyopic eyes (63.42 ± 14.05 μm, p = 0.037) and normal eyes (62.38 ± 9.65 μm, p = 0.043). The central macular thickness in amblyopic eyes (237.05 ± 37.74 μm) showed no significant differences compared to those of fellow non-amblyopic eyes (226.67 ± 34.71 μm) and normal eyes (233.74 ± 27.11 μm) (p = 0.137, p = 0.792 respectively). The macular GCIPL thickness showed no significant difference among the amblyopic, fellow non-amblyopic, and normal eyes (average; 78.94 ± 6.35 μm vs 78.77 ± 6.43 μm vs 82.22 ± 5.00 μm respectively, p > 0.05). SD-OCT analysis of deprivational amblyopic eyes with unilateral pediatric cataract demonstrated significant increase in nasal RNFL thickness compared to fellow non-amblyopic eyes and age-matched normal eyes. The macular and macular GCIPL thickness did not show any significant difference. Taken together, monocular pattern deprivation in early childhood may have changed the nasal peripapillary RNFL structure.