In vivo evaluation of macular microvasculature in childhood malnutrition using optical coherence tomography angiography.

ABSTRACT

BACKGROUND: To evaluate the microvascular alterations and foveal avascular zone (FAZ) changes in the foveal and parafoveal region in malnourished children. METHODS: This cross-sectional study analyzed 168 eyes of 85 patients. The subjects were split into 3 groups based on their body mass index (BMI) percentiles and defined as Group 1 (BMI percentiles ≥95th, overnutrition group), Group 2 (BMI <5th percentile, undernutrition group) and Group 3 (BMI ≥5th and <85th percentile, control group). All subjects were examined with optical coherence tomography angiography (OCTA) to evaluate superficial capillary plexus (SCP), deep capillary plexus (DCP) vessel density (VD) and FAZ parameters. The retinal nerve fiber layer (RNFL), average macular ganglion cell-inner plexiform layer (GCL-IPL), inner limiting membrane-retinal pigment epithelium (ILM-RPE) thickness were evaluated using SD-OCT device. RESULTS: Age and gender did not statistically differ across groups (p = 0.12 and p = 0.92). Groups 1 and 2 were found to have significantly higher VD of the superior-hemisphere of the DCP levels than the control group (p = 0.001). The control group's foveal VD of SCP was statistically higher than group 1's (p = 0.012). Parafoveal VD was significantly increased in the superior of the SCP of group 1 and the lower hemisphere of the SCP of group 2 compared with the control group (p = 0.02 and p = 0.02, respectively). The mean FAZ perimeter, choriocapillaris flow area, RNFL, GCL-IPL and ILM-RPE thickness were similar between all groups. CONCLUSION: The childhood undernutrition and overnutrition may affect the density of retinal capillaries. Although the FAZ area and choriocapillary flow did not change, retinal capillary density tended to increase in malnutrition.