The Use of the Scanning Laser Ophthalmoscope in the Evaluation of Amblyopia

Purpose: The purpose of this study was to evaluate amblyopic patients with scanning laser ophthalmoscope microperimetry to determine whether the scanning laser ophthalmoscope data provide useful information in our understanding of amblyopia and assess its utility in the evaluation of amblyopic patients. Methods: In this retrospective case-series, clinical data of 46 patients with amblyopia were examined after treatment for anisometropic or strabismic amblyopia. Ten normal patients served as controls. All patients were tested with the scanning laser ophthalmoscope, evaluating for the presence of macular scotomata. Scanning laser ophthalmoscope findings were assessed within each group and between groups. Results: A macular scotoma was found in the amblyopic eye of 25 of 26 anisometropic amblyopic patients and all 20 strabismic amblyopia patients. Twenty of 26 patients with anisometropic amblyopia had a relative scotoma in the nonamblyopic eye. All 20 patients with strabismic amblyopia had a nonamblyopic eye scotoma. None of the control patients had a scotoma in either eye. Several clinical features were correlated to scotoma findings within and between groups. Conclusions: The scanning laser ophthalmoscope proved to be a useful tool for the assessment of some features of amblyopia. A scotoma was identified in not only the amblyopic eye of all but one of the amblyopic patients, but also in almost all of the nonamblyopic, presumably “normal” eyes. Thus, ocular effects of amblyopia may not be strictly limited to the amblyopic eye. Trans Am Ophthalmol Soc 2006;104:414-436