Changes Of Subfoveal Choroidal Thickness In Form Deprivation Amblyopia After Congenital Cataract Surgery

Objective:To study the changes of subfoveal choroidal thickness in form deprivation Amblyopia after congenital cataract surgery,analyze the correlation with the best corrected visual acuity and axial length,to investigate the mechanism of choroidal changes in form deprivation Amblyopia after congenital cataract surgery.Methods:The clinical data of 50 cases with congenital cataract and concurrent cataract surgery were collected from March 2016 to March 2019 in Linyi People’s hospital.40 patients(58 eyes)were selected as the observation group according to the following criteria:(1)children with congenital cataract had the best corrected visual Acuity<0.8,or two lines and more of difference in visual acuity;(2)excluding detectable ocular lesions,such as persistent hyperplasia of primary vitreous,retinopathy and choroidal disease,congenital microphthalmia;(3)no history of ocular trauma or premature delivery.There were 22 males,18 females,22 monocular patients,18 binocular patients,aged 3～18 years(5.7±1.2),divided into three groups according to age:15 cases(20 eyes)aged from 3 to 6,12 cases(19 eyes)aged from 7 to 10,and 13 cases(19 eyes)aged from 11 to 18.Another 40 normal children(58 eyes)of the same age were selected as the control group and divided into three age groups in the same way.The follow-up period ranged from 6 months to 24 months(13.1±5.3).Ⅰ.Count the clinical data of deprivation Amblyopia of patients with congenital cataract after operation.Ⅱ.Count the clinical data of lens opacity type,nystagmus,strabismus of congenital cataract form-deprivation patients.Ⅲ.Analyze the subfoveal choroidal thickness in observation group:The subfoveal choroidal thickness,the best corrected visual acuity and eye axial length were recorded before and after the last follow-up in observation group.Statistical analyses were performed SPSS 25.0 statistical software.The measurement data are expressed as the mean standard deviation(x±s).(1)T-test of independent sampler was used to analysis the difference of subfoveal choroidal thickness before operation and normal children,after operation and normal children.P<0.05 was statistically significant.(2)Using paired t-test to analyze the difference of subfoveal choroidal thickness before and after surgery in 3 age groups.P<0.05 was statistically significant.(3)T-test of independent sampler was used to analysis the difference of subfoveal choroidal thickness between monocular patients and binocular patients in three age groups.P<0.05 was statistically significant.Ⅳ.Analyze the axial length in observation group:(1)T-test of independent sampler was used to analysis the difference of axial length between the patients and the normal children.P<0.05 was statistically significant.(2)T-test of independent sampler was used to analysis the difference of axial length between monocular patients and binocular patients in three age groups.P<0.05 was statistically significant.Ⅴ.Pearson Correlation Analysis was used to study the correlation of subfoveal choroidal thickness with visual acuity and axial length in three age groups.r<0,Negative Linear Correlation;R>0,Positive Linear Correlation;P<0.05 was statistically significant.Results:Ⅰ.Among the 50 cases of congenital cataract,40 cases had deprivation Amblyopia,accounting for 80%of congenital cataract.Ⅱ.Among the 58 eyes with deprivation Amblyopia after congenital cataract surgery,nucleus-surrounding cataract was the largest,accounting for 39.7%of the total number of eyes studied,followed by full cataract 31.0%and polar cataract 17.2%.More than two types were found in 15.5%,and 32.8%were accompanied by nystagmus or Strabismus.Ⅲ.The subfoveal choroidal thickness in observation group:The subfoveal choroidal thickness were(302.40±91.06)μm、(304.30±85.09)μm,at the time of pre-and post-operative follow-up in 3-6 years old children,and there was no significant difference(P>0.05).The subfoveal choroidal thickness were preoperative were(416.79±61.37)μm、(420.00±58.26)μm,at the time of pre-and post-operative follow-up in 7-10 years old children,and the difference was statistically significant(P<0.05).The subfoveal choroidal thickness were preoperative were(339.21±65.35)μm、(341.58±15.00)μm,at the time of pre-and post-operative follow-up in 11-18 years old children,and the difference was statistically significant(P<0.05).There was no significant difference in subfoveal choroidal thickness between monocular and binocular childrenⅣ.The axial length in observation group:(1)There were significant differences in the axial length between the control group and the last follow-up(P<0.05).(2)There was no significant difference in axial length between monocular and binocular children.Ⅴ.BCVA was converted to 5-score(4.37±0.29)、(4.55±0.21)、(4.26±0.23),there was a positive correlation between subfoveal choroid thicknesss with BCVA(r=0.704、0.665、0.658,P<0.05),there was a negative correlation between subfoveal choroid thicknesss with axial length(r=-0.628、-0.531、-0.626,P<0.05).Conclusion:The thickness of the subfoveal choroid in form deprivation Amblyopia after cataract surgery is thicker than that in normal children of the same age,and the choroidal structure changes,which is related to the best corrected visual acuity and the axial length,which provides a new clue to the mechanism of form deprivation Amblyopia.