“OCT based retinal changes in amblyopia: A systematic review”

AIM: To synthesise evidence on retinal, choroidal, and microvascular alterations detected by OCT/OCTA in amblyopic eyes and their modulation by conventional therapy. METHODOLOGY: MEDLINE, Embase, Scopus, and Cochrane CENTRAL were searched without language restrictions, along with manual screening of reference lists and relevant trial registries. Eligible studies included cross-sectional or longitudinal human studies comparing OCT/OCTA parameters in amblyopic eyes with fellow or age-matched control eyes. Two reviewers independently performed study screening, data extraction, and quality assessment. Due to substantial clinical and methodological heterogeneity among the included studies, a qualitative narrative synthesis was conducted to summarize findings across studies. Results were stratified according to amblyopia subtype and treatment status. RESULTS: Thirty studies were included. Most studies reported increased RNFLT and central macular thickness in anisometropic amblyopia, whereas findings in strabismic amblyopia were inconsistent. OCTA studies commonly demonstrated reduced superficial capillary plexus density in untreated amblyopic eyes. Longitudinal studies showed modest therapy-related structural changes, with possible earlier microvascular improvement. Methodological heterogeneity and incomplete axial-length correction were common limitations across studies. CONCLUSIONS: OCT/OCTA reveal consistent retinal thickening and superficial vascular reduction in anisometropic amblyopia, while other types show minimal changes. Standardized, axial length-corrected longitudinal studies are needed to clarify causality and prognostic significance.