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Objective: To evaluate the macular microvascular changes using optical coherence tomographic angiography (OCT-A) in children with unilateral amblyopia and their reversibility during treatment., Methods: Patients with unilateral strabismic or anisometropic amblyopia or residual amblyopia from early congenital cataract surgery, examined between October 2019 and March 2021, were included. Vessel density and perfusion density in the superficial capillary plexus and area, perimeter and circularity of the foveal avascular zone (FAZ) were analysed using OCT-A in amblyopic eyes, contralateral eyes and control group healthy eyes. Correlation analyses between the microvascular parameters and the visual acuity were performed. In a pilot study on a few patients from the amblyopic cohort, longitudinal follow-up during treatment was also performed., Results: A total of 128 eyes of 64 patients were included: 32 amblyopic eyes compared with 32 contralateral eyes and 64 control eyes. Vessel density and perfusion density in the superficial capillary plexus were significantly lower in amblyopic eyes compared to control eyes in 6 × 6 mm ( p  < 0.02) and 3 × 3 mm ( p  < 0.01) scans. Correlation analyses showed a linear decrease in vessel density and perfusion density with decreasing visual acuity. The microvascular changes observed were reversible with the occlusion treatment of amblyopia ( p  < 0.001)., Conclusions: The study found a decrease in vessel density and perfusion density in the macula of children with unilateral functional amblyopia. These microvascular changes were correlated with visual acuity and appeared to be reversible with treatment of amblyopia. On the whole, OCT-A appears to be a relevant complementary examination when it comes to diagnosing and monitoring functional amblyopia., Competing Interests: Declaration of conflicting interestsThe author(s) declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article.

Purpose: The objective of this study was to determine whether the dark adaptation time was longer in highly myopic patients than in emmetropic patients and whether there was a correlation between dark adaptation results and axial length., Patients and Methods: We conducted a retrospective study that included highly myopic patients with -6.00 dioptres or more, matched to emmetropic control patients of the same age. All patients underwent an automated adaptometry protocol that calculates the rod intercept that reflects rod-mediated dark adaptation. Axial length was measured. Colour photographs were taken to look for retinal atrophic lesions., Results: A total of 25 highly myopic patients and 25 control patients were included. The mean rod intercept was 4.38 (±1.60) min in the myopic patients and 4.27 (±1.41) min in the control patients. This difference was not statistically significant ( p = 0.79). However, in myopic patients, the longer the axial length was, the longer the dark adaptation time was ( p = 0.0003). In addition, dark adaptation was significantly longer in myopic patients with retinal pigment epithelium atrophy than in patients without lesions ( p = 0.0398)., Conclusion: In this study, dark adaptation time did not significantly differ between myopic patients and controls but was correlated with axial length in patients with severe myopia and was significantly longer in the presence of retinal pigment epithelium atrophic lesions.

Purpose: To determine the relationship of subfoveal choroidal thickness (ChT), refraction, and axial length in children, and evaluate the evolution of subfoveal ChT with time in myopic versus nonmyopic eyes., Methods: A total of 229 eyes of 115 children aged 2 to 16 years were included in the study. Refraction under cycloplegia, axial length, and subfoveal ChT were measured at baseline with comparative investigations at 15 months follow-up., Results: The probability for the subfoveal ChT to be thinner in myopic children compared to nonmyopic children was 0.9999. We found a relation between subfoveal ChT and axial length. At 15 months follow-up, subfoveal ChT was found to have increased in the nonmyopic eyes, but decreased in myopic patients., Conclusions: A number of studies have already shown the choroid to play an important role in the process of emmetropization. We found that ChT had a different evolution in myopic children compared to nonmyopic children. A thinner choroid may predict the onset, or progression, of myopia. Further studies, with longer follow-up, are necessary to confirm this hypothesis.

Purpose: The pathophysiologic pathways that govern the development of choroidal neovascularization (CNV) are complex. Patchy atrophy and lacquer cracks are known to be major anatomic risk factors for the development of myopic CNV, but they are not alone and much remains to be understood about other factors that influence development. In addition, a greater understanding of the modifiable and nonmodifiable factors that influence outcome, resolution, and recurrence after intravitreal injection of anti-vascular endothelial growth factor (VEGF) could lead to more personalized treatment algorithms that integrate parameters other than the presence of CNV itself and could help improve clinical outcomes and reduce recurrence., Methods: We reviewed recently published data on risk factors for CNV and predictors of response to anti-VEGF treatments. In particular, data pertaining to age, sex, genetic predisposition, baseline visual acuity, axial length, staphyloma, lacquer cracks, atrophic lesions, choroidal thickness or choroidal thinning, characteristics of CNV such as duration, localization, and size of CNV, and treatment considerations such as choice of treatment, loading doses, and combination treatments were reviewed., Results: Our analysis showed that the body of evidence is incomplete., Conclusions: Additional studies are required to identify high-risk patients and to develop personalized therapeutic approaches.

Purpose: To report the analysis of the cornea and the macular retina using both time domain (TD-OCT) and Fourier domain optical coherence tomography (FD-OCT) in a case of Bietti crystalline dystrophy (BCD)., Methods: This is a case study of a 32-year-old woman who presented with moderate visual loss in both eyes with nyctalopia. She had a complete ophthalmologic examination including fundus examination. She also underwent fluoroangiography, Goldmann perimetry, electroretinography/electrooculography, and both TD-OCT and FD-OCT examinations., Results: Large atrophy of retinal pigment epithelium and choroidal sclerosis were observed on both funduscopy and angiography. Microcrystals deposits were observed in the cornea and in the retina. Visual fields were constricted and electrophysiology was greatly impaired. BCD was diagnosed. TD-OCT examination was normal whereas FD-OCT revealed modifications of the outer retina and the presence of numerous lesions corresponding to microcrystals deposits in all retinal layers. The diameter of the deposits was comprised between 18 and 100 microm., Conclusions: FD-OCT was superior to TD-OCT in detecting and localizing microcrystals in BCD. FD-OCT might be useful in the understanding and the follow-up of this rare disease.