Amblyopia is a disorder of the visual developmental system in which visual acuity is decreased in the absence of clinically visible anatomic pathology. It can be caused by visual deprivation (i.e. ptosis, cataract), strabismus, and/or anisometropic refractive error and is one of the most prevalent and treatable eye diseases in children. Children who have a delay in treatment may have lifelong visual impairments. Though previous understanding of amblyopia precluded any structural ocular anomaly and was largely attributed to abnormalities of the visual cortex, recent studies have suggested otherwise. Sub-clinical changes noted in amblyopic eyes by optical coherence tomography (OCT) and optical coherence tomography angiography (OCTA) imaging that have been reported in the literature include optic nerve hypoplasia1, increased choroidal thickness2, decreased retinal outer segment layer thickness3, attenuation of the ellipsoid zone4, increased foveal thickness5, and decreased retinal capillary density6. With appropriate treatment of amblyopia, some studies have reported a measurable structural change in retinal anatomy, such as an increase in outer segment length, based on OCT imaging3.
The ability to objectively quantify structural ocular changes correlating with improvement in visual acuity in amblyopia treatment would shed light on underlying etiologies of amblyopia. Furthermore, examining the absence of structural changes or improvements on OCTA despite appropriate amblyopia treatment could potentially answer the question of why certain amblyopic children are refractory to standard-of-care treatment regimens despite good compliance.
- Children aged 4-12 years old with diagnosis of amblyopia (special population – minors)
- Amblyopia may be associated with deprivation, refractive error, and/or strabismus
- Visual acuity should be 20/30 or worse in amblyopic eye, with a 2 Snellen line difference compared to the fellow non-amblyopic eye.
- History of intraocular surgery
- History of other organic ocular disease (i.e. glaucoma, cataract, retinal detachment)
- Developmental delay
- Prematurity > 8 weeks
4 study visits required over the course of 12 months (these would be consistent with the recommendations for frequency of follow-up in amblyopic patients during the course of standard-of-care treatment). Subjects will undergo OCTA imaging for both eyes at each visit. No blood samples are required.