OCT angiography findings in children with amblyopia.

PURPOSE: To compare the microstructure and vascularity of amblyopic eyes in children with their contralateral eye and with eyes from control children using optical coherence tomography angiography (OCT-A). METHODS: We conducted a prospective, cross-sectional evaluation of macular and optic disk vascular density and flow area using OCT-A (Avanti RTVue XR, Optovue Inc, Fremont, CA). Parameters were calculated using automated software. RESULTS: A total of 52 children were included: 26 subjects with amblyopia and 26 nonamblyopic controls. The amblyopic eye of subjects showed a statistically significant decrease in macular vascular density (P = 0.0171) of the superficial capillary plexus (SCP), in the optic disk flow area (P = 0.0195) and in the average retinal nerve fiber layer thickness (P = 0.0194) as well as a marginally statistically significant decrease in the macular flow area of the SCP (P = 0.0305) and in the optic density (P = 0.0279). Compared with randomly selected eyes of controls, amblyopic eyes showed a statistically significant decrease in the macular flow area of the SCP (P = 0.005) and of the deep capillary plexus (DCP; P = 0.002), in the macula vascular density of the SCP (P = 0.022), in the optic disk flow area (P = 0.004), and a marginally statistical significant increase in the area of foveal avascular zone of the DCP (P = 0.038). CONCLUSIONS: In our study cohort amblyopic eyes manifested significant differences in macular and optic disk vascularization. The clinical significance of these findings warrants further research.

Medical and Surgical Treatment in Pediatric Orbital Myositis Associated with Coxsackie Virus.

Purpose. To report a case of orbital myositis associated with Coxsackie virus and its medical and surgical approach. Methods. Complete ophthalmological examination and imaging and analytical investigation were performed. Results. A 6-year-old male presented with subacute painless binocular horizontal diplopia. Examination revealed bilateral best-corrected visual acuity (BCVA) of 20/20 and right eye 45-prism-dioptre (PD) esotropia in near and distance fixations, with no motility restrictions. Serologic screening was positive for Coxsackie virus acute infection and computerized tomography (CT) suggested right eye medial rectus orbital myositis. An oral corticosteroid 1.0 mg/kg/day regimen was started. A new CT after two months showed symmetrical lesions in both medial rectus muscles. Corticosteroids were increased to 1.5 mg/kg/day. After imagiological resolution on the 4th month, alternating 45 PD esotropia persisted. Bilateral 7 mm medial rectus recession was performed after 1 year without spontaneous recovery. At 1-year follow-up, the patient is orthophoric with 200'' stereopsis and bilateral 20/20 BCVA. Conclusions. To our knowledge, this is the first reported case of orbital myositis associated with Coxsackie virus. This is also the first reported case of isolated strabismus surgery after orbital myositis in pediatric age, highlighting the favourable aesthetic and functional outcomes even in cases of late ocular motility disorders.