Department of Ophthalmology, Asahikawa Medical University, Asahikawa, Japan.
Singapore National Eye Centre, Singapore Eye Research Institute, Singapore.
Invest Ophthalmol Vis Sci. 2021 Mar 1;62(3):39. doi: 10.1167/iovs.62.3.39.
The purpose of this study was to characterize macular microvasculature and structural retinal layers using magnification-corrected optical coherence tomography angiography (OCTA) images in children with amblyopia.
This prospective cross-sectional study included 22 children with unilateral amblyopia (4-11 years of age) receiving spectral-domain OCTA. Vessel densities in foveal and parafoveal regions of the superficial capillary plexus (SCP) and deep capillary plexus (DCP) were measured in amblyopic and fellow eyes using a customized image analysis program correcting the scale of retinal image with axial length. Iowa Reference Algorithms (Iowa Institute for Biomedical Imaging) were used to measure mean thickness values of 10 intra-retinal layers rescaled for image size correction.
Foveal and parafoveal vessel densities in amblyopic eyes were lower than that of the fellow eyes in the SCP (fovea: P = 0.006 and parafovea: P = 0.003) and the DCP (P = 0.024 and P = 0.025, respectively). Amblyopic eyes had significantly smaller foveal avascular zone (FAZ) area than fellow eyes (P < 0.001). There were significant differences in retinal layer thickness between paired eyes, particularly in the inner retina in both foveal and parafoveal regions; retinal nerve fiber layer (RNFL) (P = 0.024 and P = 0.095, respectively), ganglion cell layer (P < 0.001 and P = 0.008), inner plexiform layer (IPL; P = 0.12 and P = 0.037), inner nuclear layer (P = 0.005 and P = 0.005), and outer plexiform layer (OPL; P = 0.02 and P = 0.057), except in the foveal IPL, the parafoveal RNFL, and OPL.
Unilateral amblyopic eyes demonstrate reduced macular vessel density and thicker inner retinal layers compared with fellow eyes even after correcting for image magnification. Changes in macular microvasculature and structural layers may offer valuable insights in the development of amblyopia.
本研究旨在通过放大校正光学相干断层扫描血管造影（OCTA）图像，对弱视儿童的黄斑微血管和结构视网膜层进行特征描述。
本前瞻性病例对照研究纳入了 22 名单侧弱视儿童（4-11 岁），他们均接受了频域 OCTA 检查。使用定制的图像分析程序，通过与眼轴长度校正视网膜图像的比例，分别在弱视眼和对侧眼的浅层毛细血管丛（SCP）和深层毛细血管丛（DCP）的中心凹和旁中心凹区域测量血管密度。使用爱荷华参考算法（爱荷华州生物医学成像研究所）来测量 10 个内视网膜层的平均厚度值，这些值经过图像大小校正的重新缩放。
弱视眼的中心凹和旁中心凹 SCP （中心凹：P = 0.006 和旁中心凹：P = 0.003）和 DCP （中心凹：P = 0.024 和旁中心凹：P = 0.025）的血管密度均低于对侧眼。弱视眼的中心凹无血管区（FAZ）面积明显小于对侧眼（P < 0.001）。配对眼之间的视网膜层厚度存在显著差异，尤其是在中心凹和旁中心凹区域的内视网膜；视网膜神经纤维层（RNFL）（P = 0.024 和 P = 0.095），节细胞层（P < 0.001 和 P = 0.008），内丛状层（IPL；P = 0.12 和 P = 0.037），内核层（P = 0.005 和 P = 0.005）和外丛状层（OPL；P = 0.02 和 P = 0.057），除了中心凹 IPL、旁中心凹 RNFL 和 OPL 外。
即使经过图像放大校正，单侧弱视眼的黄斑血管密度也低于对侧眼，且内视网膜层较厚。黄斑微血管和结构层的变化可能为弱视的发展提供有价值的见解。
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