Öner Veysi, Bulut Asker
Department of Ophthalmology, Recep Tayyip Erdoğan University Medical School, Rize, Turkey.
Clin Exp Optom. 2017 Mar;100(2):184-188. doi: 10.1111/cxo.12483. Epub 2016 Oct 18.
Recent studies have found a choroidal thickening in amblyopic eyes and suggested that there might be a relationship between the choroid and amblyopia. The present study aimed to evaluate the effect of a six-month treatment of amblyopia on choroidal thickness in anisometropic hyperopic amblyopic children.
Thirty-two anisometropic hyperopic children with unilateral amblyopia were included in this prospective study. Subfoveal choroidal thickness was measured as the distance between the retinal pigment epithelium and the chorioscleral edge, by using spectral domain enhanced depth imaging optical coherence tomography. The treatment of amblyopia was performed based on the full correction of the refractive error with eyeglasses, a refractive adaptation phase and occlusion by patching the fellow eye.
The mean visual acuity of the amblyopic eyes significantly increased from 0.35 ± 0.3 to 0.16 ± 0.2 logMAR after the treatment (p < 0.001). The mean initial choroidal thickness was significantly higher in the amblyopic eyes than in the fellow eyes (p = 0.019). There were no significant differences between the pre- and post-treatment mean choroidal thickness in the amblyopic eyes (p = 0.428) and in the fellow eyes (p = 0.343). The mean choroidal thickness was still higher in the amblyopic eyes than in the fellow eyes after the treatment (p = 0.006).
Although a six-month treatment of amblyopia increased the visual acuity of the anisometropic hyperopic amblyopic eyes, it could not significantly change choroidal thickness. Our results were in accordance with the conventional explanation, which suggests visual cortex and lateral geniculate nucleus abnormalities in the pathophysiology of amblyopia.
近期研究发现弱视眼存在脉络膜增厚，并提示脉络膜与弱视之间可能存在关联。本研究旨在评估为期六个月的弱视治疗对屈光参差性远视弱视儿童脉络膜厚度的影响。
本前瞻性研究纳入了32例单侧弱视的屈光参差性远视儿童。使用光谱域增强深度成像光学相干断层扫描技术，测量黄斑中心凹下脉络膜厚度，即视网膜色素上皮与脉络膜巩膜边缘之间的距离。弱视治疗基于通过眼镜完全矫正屈光不正、屈光适应期以及遮盖对侧眼进行。
治疗后，弱视眼的平均视力从0.35±0.3显著提高至0.16±0.2 logMAR（p<0.001）。弱视眼的平均初始脉络膜厚度显著高于对侧眼（p = 0.019）。弱视眼治疗前后的平均脉络膜厚度（p = 0.428）以及对侧眼治疗前后的平均脉络膜厚度（p = 0.343）均无显著差异。治疗后，弱视眼的平均脉络膜厚度仍高于对侧眼（p = 0.006）。
尽管为期六个月的弱视治疗提高了屈光参差性远视弱视眼的视力，但并未显著改变脉络膜厚度。我们的结果与传统解释一致，即弱视病理生理学中存在视皮层和外侧膝状体异常。
