Changes in peripapillary retinal nerve fiber layer thickness, macular fovea thickness, and perimacular retinal nerve fiber layer thickness in children with hyperopic amblyopia.

Objective

To compare peripapillary retinal nerve fiber layer thickness (RNFLT), macular foveal thickness, and perimacular RNFLT in children with hyperopic amblyopia using optical coherence tomography (OCT).

Methods

This retrospective case-control study included 140 children (214 eyes) with hyperopic amblyopia and 60 normal children (120 eyes) examined from June 2023 to June 2024. Amblyopia severity was classified according to best-corrected visual acuity (BCVA) in the amblyopic eye as mild (20/32-20/40), moderate (>20/40-20/100), or severe (>20/100). OCT was used to measure peripapillary RNFLT, foveal thickness, and perimacular RNFLT. Correlations with axial length and spherical equivalent refraction were analyzed, and multivariable logistic regression was performed.

Results

Compared with controls, children with moderate and severe amblyopia had significantly greater peripapillary RNFLT, macular foveal thickness, and inner-ring perimacular RNFLT (P<0.05). Severe amblyopia showed thicker superior, nasal, and temporal peripapillary RNFLT and greater foveal thickness than mild amblyopia (P<0.05). Peripapillary RNFLT was positively correlated with spherical equivalent refraction. Superior peripapillary RNFLT, superior inner-ring perimacular RNFLT, and foveal thickness were independently associated with moderate-to-severe amblyopia (P<0.05).

Conclusion

OCT demonstrates progressive thickening of selected peripapillary and macular structural parameters with increasing amblyopia severity. These parameters may serve as objective adjunctive markers for severity assessment and follow-up in children with hyperopic amblyopia.