| Purpose Amblyopia has become one of the common eye diseases of children in China.Amblyopia is defined as that the best vision of one or both eyes after refractive correction cannot reach the normal vision of the corresponding age,and there is no clear organic disease in the eyes.Its developed treatment methods have reached international consensus,but the current understanding of the etiology of amblyopia is not complete.With the development of more advanced and convenient examination methods,some scholars have found that there may be some structure changes in the choroid and microvascular system of amblyopia.The main purpose of this study is to use optical coherence tomography angiography(OCTA)to explore whether the choroidal thickness,the area of the central fovea without blood vessels,the superficial capillary plexus vascular density and the deep capillary plexus vascular density of amblyopic children are different from those of normal children.Methods We recruited 30 children with monocular amblyopia aged more than 5 years old from the pediatric ophthalmology clinic of the Second Hospital of Dalian Medical University.Their amblyopia type was diagnosed as anisometropic amblyopia and strabismus amblyopia.No other eye diseases and no treatment and surgery related to the eyes were recruited.At the same time,15 age-and sex-matched children with normal vision were recruited,a total of 90 eyes.We divided them into three groups,namely amblyopia group(30 eyes),the contralateral eye group(30 eyes)and the normal control group(30 eyes).Then all the eyes were examined by OCT and OCTA respectively by two doctors to obtain the images of choroidal thickness,the area of central fovea without blood vessels,the superficial capillary plexus and the deep capillary plexus of all the eyes.Then import the images into Image J to measure the blood vessel density.After correcting the difference of choroidal thickness and the size of vascular density image caused by different eye axis lengths,the final statistical raw data is obtained.Take the average value of the data measured by the two doctors to eliminate the statistical result deviation caused by the measurement error.Then the normality test was carried out on all the original data,and it was found that each group of data did not meet the characteristics of normal distribution.Since the normal distribution is not satisfied and the three sets of data need to be compared in pairs,Kruskal-Wallis test(KW test)is selected immediately.Then all the data were imported into SPSS 25.0 for data analysis,and the final statistical data was obtained,which was considered statistically significant when p<0.05.Results The age range of 30 children with amblyopia is 8.5 ± 2.9 years old(5.6-11.4 years old),including 13 males,accounting for 43.33% of children with monocular amblyopia,25 children were diagnosed as anisometropic amblyopia,accounting for 83.3% of monocular amblyopia children.The age range of 15 children in the normal vision control group is 8.75 ± 2.75 years(6.0-11.5 years),of which 6 are male,accounting for 40% of the normal vision control group.There was no significant difference in age and sex between the two groups.The intraocular pressure,eye movement,anterior and posterior segments of all participants were normal,the equivalent spherical of amblyopia group was significantly greater than that of the contralateral eye group and the normal control group(both p=0.00),the best corrected visual acuity of amblyopia group was significantly lower than that of the contralateral eye group and the normal control group(both p=0.00).There was no significant difference in the best corrected visual acuity between the contralateral eye group and the normal control group(p=1.00).The axial length of amblyopia group and contralateral eye group was significantly shorter than that of normal control group(both p=0.00).For the statistical analysis of choroidal thickness,amblyopia group(346.5 ± 76.5 μ m,mean 340.33 μ m)compare to the contralateral eye group(317 ± 60 μ m,mean 324.73 μ m)were obviously thick(p=0.02);the amblyopia group was significantly thicker than the normal control group(317 ± 60 μ m,mean 296.7μm)(p=0.01);there was no significant difference between the contralateral eye group and the normal control group(p=1.00).For the analysis of the area of the central fovea without blood vessels,there was no significant difference between the amblyopia group(0.365 ± 0.045 mm2,mean 0.353 mm2)and the contralateral eye group(0.37 ± 0.03 mm2,mean 0.362 mm2);there is no significant difference between amblyopia group and normal control group(0.39 ± 0.03 mm2,mean 0.363 mm2);there was no significant difference between the contralateral eye group and the normal control group;and the progressive significance measured by KW test is 0.078.The results show that there is no significant difference among the three groups of data.For the analysis of vascular density of superficial capillary plexus,the amblyopia group(42.47 ± 3.37%,mean 42.10%)was significantly reduced in the contralateral eye group(43.19 ± 3.37%,mean 43.52%)(p=0.034);compared with the normal control group(43.01 ± 3.83%,mean 43.59%),the amblyopia group was significantly reduced(p=0.025);there was no significant difference between the contralateral eye group and the normal control group(p=1.00).For the analysis of vascular density of deep capillary plexus,the amblyopia group(44.34 ± 2.71%,mean 44.26%)was significantly less than the contralateral eye group(45.63 ± 2.32%,mean 45.52%)(p=0.029);compared with the normal control group(46.57 ± 4.12%,mean 46.20%),amblyopia group was significantly reduced(p=0.02);there was no significant difference between the contralateral eye group and the normal control group(p=1.00).Conclusion The choroidal thickness of amblyopic children’s amblyopic eyes was significantly thickened,and the superficial capillary plexus vascular density and the deep capillary plexus vascular density were smaller than those of normal eyes.However,the area of the central fovea without blood vessels was not significantly different among three groups. |
PDF Full Text Request