Evaluation of Subfoveal Choroidal Thickness and Choroidal Flow Area in Children with Unilateral Amblyopia

Abstract

Aim: This study aimed to assess alterations in subfoveal choroidal thickness and choriocapillaris flow area in children diagnosed with hyperopic anisometropic, strabismic, and deprivation amblyopia, and to compare these findings with those obtained from fellow healthy eyes and age-matched control subjects.Materials and Methods: This prospective study included 48 children with unilateral amblyopia and 20 healthy control subjects matched for age and sex, all aged between 12 and 18 years. Subfoveal choroidal thickness measurements were obtained using enhanced depth imaging optical coherence tomography (EDI-OCT), while choriocapillaris flow parameters were assessed by optical coherence tomography angiography (OCTA). Differences among the study groups were analyzed using the Kruskal–Wallis test, with subsequent post hoc comparisons when applicable. Correlation analyses were performed to investigate the relationship between best-corrected visual acuity and choroidal parameters.Results: Both subfoveal choroidal thickness and choriocapillaris flow area were significantly greater in amblyopic eyes than in the contralateral non-amblyopic eyes as well as in the healthy control eyes (p < 0.05). In contrast, no statistically meaningful difference was identified between the fellow eyes of patients with amblyopia and the control group. Furthermore, visual acuity showed a moderate positive association with subfoveal choroidal thickness (r = 0.622) and choriocapillaris flow area (r = 0.596), with both correlations reaching statistical significance (p < 0.05).Conclusions: Increased subfoveal choroidal thickness and enlarged choriocapillaris flow area in amblyopic eyes suggest that choroidal structural and vascular alterations may play a role in the pathophysiology of amblyopia. These parameters may represent potential biomarkers for the evaluation of amblyopia and for predicting treatment response in future studies.