Changes in peripapillary retinal nerve fiber layer thickness, macular fovea thickness, and perimacular retinal nerve fiber layer thickness in children with hyperopic amblyopia.

OBJECTIVE: To compare peripapillary retinal nerve fiber layer thickness (RNFLT), macular foveal thickness, and perimacular RNFLT in children with hyperopic amblyopia using optical coherence tomography (OCT). METHODS: This retrospective case-control study included 140 children (214 eyes) with hyperopic amblyopia and 60 normal children (120 eyes) examined from June 2023 to June 2024. Amblyopia severity was classified according to best-corrected visual acuity (BCVA) in the amblyopic eye as mild (20/32-20/40), moderate (>20/40-20/100), or severe (>20/100). OCT was used to measure peripapillary RNFLT, foveal thickness, and perimacular RNFLT. Correlations with axial length and spherical equivalent refraction were analyzed, and multivariable logistic regression was performed. RESULTS: Compared with controls, children with moderate and severe amblyopia had significantly greater peripapillary RNFLT, macular foveal thickness, and inner-ring perimacular RNFLT (P<0.05). Severe amblyopia showed thicker superior, nasal, and temporal peripapillary RNFLT and greater foveal thickness than mild amblyopia (P<0.05). Peripapillary RNFLT was positively correlated with spherical equivalent refraction. Superior peripapillary RNFLT, superior inner-ring perimacular RNFLT, and foveal thickness were independently associated with moderate-to-severe amblyopia (P<0.05). CONCLUSION: OCT demonstrates progressive thickening of selected peripapillary and macular structural parameters with increasing amblyopia severity. These parameters may serve as objective adjunctive markers for severity assessment and follow-up in children with hyperopic amblyopia.