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Evaluation of Long-term Posterior Segment Parameters in Children Who Had Recovered From Multisystem Inflammatory
Insights
Children recovering from multisystemic inflammatory syndrome (MIS-C) may experience long-term retinal vascular damage. Follow-up eye exams using OCT and OCT-A can help monitor these effects.
Area of Science:
- Ophthalmology
- Pediatrics
- Infectious Diseases
Background:
- Multisystemic inflammatory syndrome (MIS-C) in children is a serious condition linked to SARS-CoV-2.
- Long-term ocular complications of MIS-C are not well understood.
- Posterior segment findings require further investigation.
Purpose of the Study:
- To evaluate long-term posterior segment findings in children after MIS-C.
- To assess retinal microvasculature changes in recovered MIS-C patients.
- To compare ocular parameters between MIS-C survivors and healthy controls.
Main Methods:
- Retrospective analysis of 22 MIS-C patients and 25 healthy controls.
- Eye examinations conducted an average of 12 months post-MIS-C recovery.
- Utilized swept-source OCT and OCT-angiography (OCT-A) to measure pRNFL, CMT, SCT, VD, and FAZ.
Main Results:
- No significant differences in pRNFL thickness, CMT, or SCT between groups.
- MIS-C survivors showed significantly lower macular vascular densities (VD) in all quadrants.
- No significant differences in foveal avascular zone (FAZ) area were observed.
Conclusions:
- Children recovering from MIS-C can exhibit long-term retinal vascular damage.
- Noninvasive OCT and OCT-A are valuable for monitoring MIS-C's long-term ocular effects.
- Further research is needed to understand the impact of MIS-C on retinal microvasculature.
Background And Objective:
To evaluate long-term posterior segment findings in children recovering from multisystemic inflammatory syndrome (MIS-C) associated with severe acute respiratory syndrome coronavirus 2.
Patients And Methods:
Our study included 22 patients who were admitted to an intensive care unit with a diagnosis of MIS-C between November 2021 and March 2022, and 25 healthy controls. The study included pediatric patients who had an eye examination an average of 12.35 ± 2.18 months after recovery from MIS-C. Detailed eye examinations and measurements of all participants were obtained retrospectively from patient files. Posterior segment parameters were measured using swept-source optical coherence tomography (OCT) and OCT-angiography (OCT-A); these parameters included peripapillary retinal nerve fiber layer (pRNFL) thickness, central macular thickness (CMT), subfoveal choroidal thickness (SCT), macular vascular densities (VD), and foveal avascular zone (FAZ) area.
Results:
Mean age was 9.7 ± 3.6 years in the MIS-C group and 10.6 ± 2.8 years in the healthy control group (P = 0.316). There were no statistically significant differences between the MIS-C group and the healthy control group in terms of pRNFL thickness, CMT, and SCT. However, in the MIS-C group, the macular superficial vascular plexus and deep vascular plexus showed significantly lower VD in the superior, inferior, nasal, and temporal quadrants compared to the healthy controls (P < 0.05 for all). A comparison of the superficial and deep FAZ area parameters of both groups showed no statistically significant difference (P > 0.05).
Conclusions:
We showed that patients who had recovered from MIS-C had retinal vascular damage at the long-term follow-up. Following up with these patients after recovery with OCT and OCT-A, which are noninvasive methods commonly used in the detailed evaluation of the posterior segment of the eye, could be beneficial for understanding the long-term effects of MIS-C on retinal microvasculature. [Ophthalmic Surg Lasers Imaging Retina 2024;55:518-526.].
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