Gaier Eric D, Gise Ryan, Heidary Gena
a Department of Ophthalmology , Boston Children's Hospital , Boston , MA , USA.
b Harvard Medical School , Boston , MA , USA.
Semin Ophthalmol. 2019;34(4):303-311. doi: 10.1080/08820538.2019.1620810. Epub 2019 Jun 3.
Amblyopia refers to visual impairment resulting from perturbations in visual experience during visual development, typically secondary to strabismus, uncorrected refractive error, and/or deprivation. Amblyopia has traditionally been considered a cortical disease, but the depth of our understanding of this complex neurodevelopmental condition is limited by our ability to appreciate structural pathophysiology in the visual pathway. Recent advances in Optical Coherence Tomography (OCT) have facilitated numerous studies of the structural changes in the retina and optic nerve, thereby expanding our appreciation for the pathogenesis of this condition. In this review, we summarize findings from studies evaluating retinal, retinal nerve fiber layer, and choroidal thickness changes in patients with amblyopia. Focusing on the largest and most recent studies, we discuss common limitations and confounding variables in these studies. We summarize recent advances in ocular imaging technology and reconcile the findings of early histological reports with those of structural OCT in amblyopia.
弱视是指在视觉发育过程中,由于视觉经验受到干扰而导致的视力损害,通常继发于斜视、未矫正的屈光不正和/或视觉剥夺。传统上,弱视被认为是一种皮质疾病,但我们对这种复杂的神经发育状况的理解深度受到我们理解视觉通路中结构病理生理学能力的限制。光学相干断层扫描(OCT)的最新进展促进了对视网膜和视神经结构变化的大量研究,从而扩大了我们对这种疾病发病机制的认识。在这篇综述中,我们总结了评估弱视患者视网膜、视网膜神经纤维层和脉络膜厚度变化的研究结果。聚焦于规模最大和最新的研究,我们讨论了这些研究中常见的局限性和混杂变量。我们总结了眼部成像技术的最新进展,并将早期组织学报告的结果与弱视患者结构OCT的结果进行了协调。