OCT-Angiography Insights into Amblyopia: Comparative Analysis of Healthy, Treatment-Responsive, and Treatment-Resistant Cases

Amblyopia is a developmental visual disorder characterized by reduced best-corrected visual acuity without an identifiable structural cause, often leading to lifelong visual impairment if untreated. Optical Coherence Tomography Angiography (OCT-A) provides a non-invasive, high-resolution assessment of retinal and choroidal microvasculature, offering novel insights into the structural underpinnings of amblyopia. This review critically examines OCT-A findings in amblyopic patients, contrasting data from healthy controls, treatment-responsive amblyopic eyes, and treatment-unresponsive cases. Quantitative analyses reveal that amblyopic eyes, particularly those unresponsive to treatment, demonstrate significantly reduced vessel density in both the superficial and deep capillary plexuses, enlargement of the foveal avascular zone (FAZ), and alterations in central retinal thickness compared to healthy counterparts. Treatment-responsive amblyopic eyes tend to exhibit partial normalization of these parameters, suggesting microvascular plasticity. Persistent deviations in treatment-unresponsive cases may reflect irreversible neurovascular disruption. These findings position OCT-A as a valuable adjunct in the diagnosis, prognostication, and management of amblyopia, with potential implications for individualized therapeutic strategies.