Work

Morphologic and functional assessment of photoreceptors in anisometropic amblyopia using adaptive optics scanning laser ophthalmoscopy

Year: 2025

Type: article

Abstract: • Amblyopic eyes show disrupted macular cone spatial distribution, including significantly reduced cone density and regularity, and increased cone spacing. • Cone density and regularity were identified as the strongest independent predictors of contrast sensitivity function in patients with anisometropic amblyopia. • Amblyopic eyes exhibited increased retinal and choroidal thickness compared to fellow and normal eyes. • Microcirculatory perfusion, specifically superficial capillary plexus vessel density (SCP-VD) and choroidal vascularity index (CVI), was reduced in amblyopic eyes. • Adaptive optics scanning laser ophthalmoscopy (AO-SLO) is a valuable tool for assessing retinal deficits in developmental visual disorders. Using adaptive optics scanning laser ophthalmoscopy (AO-SLO) to investigate the cone photoreceptor structure in children with anisometropic amblyopia and to examine its correlation with contrast sensitivity function (CSF). Fifteen patients with monocular anisometropic amblyopia (amblyopic eyes, AE; fellow eyes, FE) and 15 age-matched controls (normal eyes, NE) were enrolled (45 eyes). Data on macular cone photoreceptor density, spacing, and regularity; retinal and choroidal thickness; superficial capillary plexus vessel density (SCP-VD); choroidal vascularity index (CVI); and contrast sensitivity function (CSF) were collected. Statistical analyses were performed using one-way analysis of variance (ANOVA), Pearson correlation, and multivariate linear regression. Compared to the FE and NE groups, the AE group showed significantly reduced cone density (28,519.12 ± 2,853.41 vs. 35,529.21 ± 2,217.35 and 36,181.62 ± 3,081.95 cells/mm², P < 0.01), increased spacing (6.36 ± 1.64 vs. 4.22 ± 0.41 vs. 4.13 ± 0.50 μm, P < 0.01), and decreased regularity (92.99 ± 1.49% vs. 95.86 ± 1.20% vs. 95.90 ± 1.03%; P < 0.01). The Area Under the Log Contrast Sensitivity Function (AULCSF) of the AE group (1.61 ± 0.08) was significantly lower than that of the FE (1.84 ± 0.04) and NE groups (1.87 ± 0.08; P < 0.01). CSF was positively correlated with cone density ( R² = 0.899, P < 0.001) and regularity ( R² = 0.530, P = 0.002) and negatively correlated with cone spacing ( R² = 0.539, P = 0.002). Multivariate regression analysis revealed that cone density ( β = 0.701, P < 0.001) and cone regularity ( β = 0.228, P = 0.026) had a positive predictive effect on AULCSF. Anisometropic amblyopia shows disrupted macular cone structure, including reduced density and irregular spacing, which closely relates to impaired contrast sensitivity. AO-SLO can help assess these retinal deficits in developmental visual disorders.

Source: Photodiagnosis and Photodynamic Therapy

DOI: 10.1016/j.pdpdt.2025.105241