Effect of Amblyopia Therapy on Retinal and Choroidal Thickness in Children With Unilateral Anisometropic Amblyopia: A Prospective Longitudinal Study.

Introduction Anisometropic amblyopia is a leading cause of preventable monocular visual impairment in children. Traditionally considered a cortical developmental disorder, recent advances in optical coherence tomography (OCT) have demonstrated measurable structural alterations in the retina and choroid of amblyopic eyes. These findings suggest that amblyopia may also involve retinal and choroidal components. Objective To evaluate longitudinal changes in retinal and choroidal thickness following amblyopia therapy in children with unilateral anisometropic amblyopia. Methods This prospective longitudinal study included 26 children aged 6-18 years diagnosed with unilateral anisometropic amblyopia. Best-corrected visual acuity (BCVA), foveal thickness (FT), macular thickness (MT), subfoveal choroidal thickness (SFCT), and retinal nerve fiber layer thickness (RNFLT) were assessed in both amblyopic and fellow eyes using OCT. Measurements were obtained at baseline and at 3, 6, and 12 months following amblyopia therapy. Baseline interocular comparisons and longitudinal changes in the amblyopic eye were analyzed. Results At baseline, the mean BCVA of the amblyopic eye was 0.70 ± 0.18 logMAR compared to 0.00 logMAR in the fellow eye. Mean baseline FT was 267.63 ± 15.1 µm in amblyopic eyes versus 233.83 ± 11.4 µm in fellow eyes. Mean MT was 278.90 ± 16.8 µm versus 244.10 ± 12.6 µm, SFCT was 355.31 ± 27.1 µm versus 280.63 ± 18.9 µm, and RNFLT was 103.85 ± 6.9 µm versus 98.66 ± 5.3 µm in amblyopic and fellow eyes, respectively. During follow-up, mean BCVA improved progressively from 0.70 ± 0.18 logMAR at baseline to 0.40 ± 0.15 at 3 months, 0.30 ± 0.13 at 6 months, and 0.20 ± 0.10 at 12 months. Mean FT decreased from 267.63 ± 15.1 µm to 252.10 ± 14.3 µm, MT from 278.90 ± 16.8 µm to 263.20 ± 16.2 µm, and SFCT from 355.31 ± 27.1 µm to 334.60 ± 25.7 µm over 12 months. RNFLT remained relatively unchanged throughout the study period. Conclusions Children with unilateral anisometropic amblyopia show increased retinal and choroidal thickness compared to the fellow eye. With treatment, visual acuity improves significantly, along with reductions in foveal, macular, and SFCT, while RNFLT remains largely unchanged. However, these structural changes should be interpreted as associations rather than definite effects of therapy, given the presence of potential confounding factors.