Macular and optic disc vascular densities measured by optical coherence tomography angiography in pediatric patients with different amblyopia types

Abstract

Purpose The present study aimed to compare macular and peripapillary vascular density values measured by optical coherence tomography angiography (OCTA) in different types of amblyopia (ametropic amblyopia, anisometropic amblyopia, strabismic amblyopia, deprivation amblyopia) with age- and gender-matched healthy controls. Materials and methods In this prospective, cross-sectional study, between the ages of 8-18 years, 32 eyes of 32 patients with hypermetropic ametropic amblyopia and 21 amblyopic eyes of 21 patients with hypermetropic anisometropic amblyopia, 15 amblyopic eyes of 15 patients with strabismic amblyopia due to esotropia, 12 amblyopic eyes of 12 patients with deprivation amblyopia, and 30 eyes of 30 emmetropic individuals aged 8-18 years without any ocular pathology who were admitted to the same clinic were included in the control group. Refractive errors and best-corrected visual acuity (BCVA) with the Snellen chart were recorded as LogMAR. In all cases, superficial vascular plexus and deep vascular plexus whole image vessel density, foveal vessel density, parafoveal vessel density, perifoveal vessel density, and foveal avascular zone area (FAZ) values were measured and recorded for macular vascular density determination with OCTA. The whole image, intrapapillary, and peripapillary vessel density measurements were performed for peripapillary vessel density determination. The Kruskal-Wallis test was used for statistical analysis and the post hoc test was used for inter-group comparisons. Results The mean BCVA (LogMAR) was found to be significantly lower in the anisometropic amblyopia, strabismic amblyopia, and deprivation amblyopia groups (unilateral amblyopia) compared to the ametropic amblyopia (bilateral amblyopia) and healthy group (p < 0.001). The whole image vessel density, foveal vessel density, and parafoveal vessel density of superficial and deep vascular plexus were found to be significantly lower in anisometropic amblyopia, strabismic amblyopia, and deprivation amblyopia compared to ametropic amblyopia and healthy volunteers (p < 0.001). In the correlation analysis, a negative correlation was found between the mean visual acuity in LogMAR and superficial vascular plexus foveal vessel density (p < 0.001, r = - 0.622), superficial vascular plexus parafoveal vessel density (p < 0. 001, r= -0.556), deep vascular plexus foveal vessel density (p < 0.001, r= -0.636), and deep vascular plexus parafoveal vessel density (p < 0.001 r=-0.596). Conclusion Superficial and deep vascular plexus vessel densities in the macular region are affected in anisometropic amblyopia, strabismic amblyopia, and deprivation amblyopia, and OCTA may be useful in detecting these changes.