Spectral-Domain Optical Coherence Tomographic Angiography in Children With Amblyopia

Abstract

IMPORTANCE Amblyopia is the most common cause of visual impairment in childhood, with a prevalence of 1% to 4% in children in the United States. To date, no studies using noninvasive optical coherence tomographic angiography (OCTA) have measured blood flow in the retinal capillary layers in children with amblyopia.OBJECTIVE To evaluate the retinal and microvascular features using OCTA in children (<18 years) with amblyopia.

Quantitative retinal microvasculature in children using swept-source optical coherence tomography: the Hong Kong Children Eye Study

“…Furthermore, we observed a positive correlation between AL and VD—subjects with shorter eye ball having lower VD. Our finding was in line with Lonngi et al ’s39 study that amblyopic eyes have lower VD as measured from OCT-A, compared with control eyes. We also found that decreased VDI, indicating retinal vessel narrowing, is associated with increased AL.…”

Retinal Microvasculature in Amblyopic Children and the Quantitative Relationship Between Retinal Perfusion and Thickness

“…Our data are not in perfect agreement with previous studies. 6,7,10 Lonngi et al 6 and Yilmaz et al 7 reported decreased SCP and DCP vessel density for amblyopic eyes, but not for the FAZ in amblyopic eyes. Sobral et al 10 found decreased SCP vessel density and an enlarged FAZ in amblyopic eyes.…”

“…11 In 2018, the updated optical software (Optovue, Inc.) redefined the SCP and DCP boundaries and 3D projection artifacts removal algorithms were implemented to remove ''false'' blood flow signals in the DCP. Lonngi et al 6 and possibly others 9-10 did not use the updated software, and the differences in analytical software might have caused the inconsistency among studies in the estimates of macular vessel density in the DCP. In our study, SCP vasculature was compromised more than the DCP in relation to the abnormal amblyogenic factors such as visual experience or the central visual system defect caused by these factors.…”

“…Previous studies have suggested that the development of both eyes is affected in people with unilateral amblyopia and that the fellow eye is not equivalent to a normal healthy eye. 12,13 Lonngi et al 6 included some fellow eyes as control eyes, and this may have introduced an artifact into their results. Our data showed that in fellow eyes, the SCP was slightly less dense than in control eyes at each site measured, and the differences were significant at several sites.…”

“…Several authors reported decreased SCP and DCP vessel density for amblyopic eyes. 6,7 However, the projection artifacts in the DCP might exist in the previous studies. This is an especially propitious time to perform OCTA studies because recent software advances of certain OCTA systems can now largely eliminate imaging artifacts in the DCP.…”