Assessment of Superficial Vascular Density in the Unilateral Amblyopic Eyes by Using Optical Coherence Tomographic Angiography.

Abstract

Objective: To assess the superficial vascular density (SVD) in the foveal avascular zone (FAZ) of the unilateral aniso-metropic amblyopic eye by utilizing the optical coherence tomography angiography.
Methodology: The present study was conducted during the period from February 2023 to November 2024, at the Insti-tute of Ophthalmology at Liaquat University of Medical & Health Sciences (LUMHS) Jamshoro Pakistan. The partici-pants included 50 children with unilateral anisometropic amblyopia was referred by the pediatric ophthalmology clinic of IOL LUMHS. All patients received a full eye checkup, which included testing their vision, assessing their refraction, measuring axial length, and examining both the front and back parts of the eye. An inbuilt proprietary software of OCTA was used to scan the 3 × 3-mm area of the foveal area to quantify the SVP at the horizontal and vertical axis.
Results: The two groups have shown a clear-cut distinction in visual acuity. The amblyopic eyes have a better correct-ed visual acuity of 20/ 64 {Logarithm of the Minimum Angle of Resolution; (logMAR) 0.51 ± 0.17}, with values ranging from 20/40 to 20/126 (logMAR 0.30–0.80). Conversely, the fellow eyes evidences better vision, with an average BCVA of 20/ 18 (logMAR −0.03 ± 0.05), which ranges between 20/ 15 and the 20/ 20 (logMAR −0.12 to 0.00). The overall, differ-ence among the two groups was significant, with a mean logMAR gap of 0.54 (95% CI, 0.45–0.63; P < .001). Although the amblyopic eyes usually show hyperopia > 3 diopters. The two groups were not considerably different in terms of equivalent cylinder, sphere, or spherical refraction.
Conclusion: Amblyopic eyes showed greater hyperopia, shorter axial lengths, and reduced visual acuity, consistent with prior reports on anisometropic amblyopia. OCT‑A revealed decreased superficial and deep capillary densities, suggest-ing microvascular alterations—particularly in the deep plexus—as potential biomarkers of amblyopia severity and thera-peutic response.
Keywords: Amblyopic FAZ, OCT of amblyopic eyes, superficial vascular Density, superficial vascular plexus of amblyop-ic eyes.