Evaluation of Retinal Microvascular Features in Patients with Amblyopia Based on Optical Coherence Tomography Angiography: A Systematic Review and Meta-Analysis

Abstract

Background: The performance of optical coherence tomography angiography (OCTA) in macular microvasculature of patients with amblyopia has been widely studied, but these studies have yielded different and controversial results. Objectives: To investigate retinal microvascular features in patients with amblyopia undergoing OCTA. Methods: PubMed, Embase, and Web of Science were searched for published articles comparing the retinal microvascular features between individuals with amblyopia and controls until April 2022. The mean difference with a 95% confidence interval was used to assess continuous variables. Results: The analysis included 17 studies. The whole vessel density of the superficial capillary plexus (SCPVD) was lower in amblyopic eyes (AE) than in normal control eyes (NE) in 3 × 3 mm2 scans, while the perifoveal vessel density of superficial and deep capillary plexus was lower in 6 × 6 mm2 scans. The whole parafoveal vessel density of deep capillary plexus (DCPVD) and parafoveal-SCPVD were lower in both scans. The comparison between amblyopic eyes and fellow eyes (FE) revealed no statistical difference in all quadrants except the parafoveal and perifoveal-SCPVD and the foveal-DCPVD. Additionally, SCPVD in all quadrants except the fovea and DCPVD in all quadrants except the parafoveal were higher in fellow eyes compared to normal control eyes. No significant difference was found in the foveal avascular area between AE and NE, AE and FE, or NE and FE. Conclusions: The retinal vessel density of superficial and deep capillary plexus in amblyopic and fellow eyes was lower than in normal controls, and differences were more likely discovered using 6 × 6 mm2 scans. Consequently, OCTA may be utilized as a diagnostic tool to identify and monitor patients with amblyopia.

Repeatability of retinal and choroidal optical coherence tomography angiography indices in healthy children and young adults

“…Various studies have used OCT-A to study retinal and choroidal microvasculature in children with ocular diseases such as amblyopia, retinopathy of prematurity, sickle cell disease and type 1 diabetes, and suggested OCT-A to be a promising device to diagnose and monitor these diseases. [44][45][46][47] The present investigation provides repeatability ranges for retinal (superficial and deep layers) and choroidal (choriocapillaris and deep choroid) OCT-A indices between which the indices were repeatable in healthy children, aiding the diagnosis and monitoring of these ocular conditions. This will improve the routine clinical utilisation of OCT-A in children, which is otherwise limited apart from research purposes.…”

OCT-Angiography Findings in Children with Anisometropic Amblyopia

“…Feng at al. published the results of a meta-analysis regarding microvascular features in patients with amblyopia based on OCTA, and found out that in the majority of studies on retinal vessel density were lower in amblyopic eyes and also in fellow eyes compared to normal eyes, and concluded that differences are easily found using 6 × 6 mm scans [ 21 ].…”

“…With the advances in optical coherence tomography [OCT] and OCT angiography [OCTA] as new non-invasive diagnostic procedures, further investigations of retinal changes were possible without exposing the patients to any risk and can also be performed for amblyopic eyes in children [ 19 , 20 , 21 ].…”