Macular Retinal Layer Thickness in Patients with Severe Congenital Ptosis with and without Amblyopia.
TL;DR
Patients with severe congenital ptosis and amblyopia exhibit distinct alterations in macular retinal layer thickness compared with both patients without amblyopia and healthy controls, suggesting that amblyopia secondary to severe congenital ptosis may lead to altered macular retinal architecture.
Abstract
Objective
To evaluate macular retinal layer thickness in patients with severe congenital ptosis with and without amblyopia and compare the findings with those of healthy controls.
Methods
This cross-sectional study included 69 patients (87 eyes) with severe congenital ptosis, comprising 32 patients (40 eyes) with amblyopia and 37 patients (47 eyes) without amblyopia, together with 38 healthy controls (38 eyes). Macular retinal thickness was measured using optical coherence tomography angiography (OCTA). Automated segmentation quantified the inner five retinal layers (IRT), outer five retinal layers (ORT), and full retinal thickness (FRT) in the fovea, parafovea, and perifovea. Group differences were analyzed using analysis of covariance with adjustment for axial length (AL). Spearman rank correlation analysis was performed to assess the associations of foveal retinal thickness with AL, age, sex, and the relationship between foveal IRT and ORT.
Results
Compared with healthy controls, patients with amblyopia showed significantly thinner IRT in most macular regions and significantly thicker ORT across the fovea, parafovea, and perifovea (all P<0.05). Compared with patients without amblyopia, the amblyopia group exhibited thinner IRT and thicker ORT in multiple parafoveal and perifoveal regions (all P<0.05). Patients without amblyopia also had thicker ORT than healthy controls in the parafovea and temporal perifovea (all P<0.05). These differences remained significant after adjustment for AL. Foveal ORT was positively correlated with foveal IRT in the amblyopia (rₛ=0.672), non-amblyopia (rₛ=0.417), and healthy control groups (rₛ=0.611) (all P≤0.005).
Conclusions
Patients with severe congenital ptosis and amblyopia exhibit distinct alterations in macular retinal layer thickness compared with both patients without amblyopia and healthy controls. These differences persist after adjustment for axial length, suggesting that amblyopia secondary to severe congenital ptosis may lead to altered macular retinal architecture.