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Ocular hemodynamics in multisystem inflammatory syndrome in children: A cross-sectional study
Sule Gokcek Gurturk Icoz1, Mucella Arıkan Yorgun2, Gulsum Iclal Bayhan3
1Department of Ophthalmology, Yozgat City Hospital, Yozgat, Türkiye.
Insights
Optical coherence tomography angiography (OCTA) revealed no significant retinal vascular changes in children 6 months after multisystem inflammatory syndrome (MIS-C) or COVID-19. This suggests ocular hemodynamics may not be detectably altered on OCTA in pediatric patients post-infection.
Area of Science:
- Ophthalmology
- Pediatric Medicine
- Infectious Diseases
Background:
- Multisystem inflammatory syndrome in children (MIS-C) is a rare but serious condition following SARS-CoV-2 infection.
- Retinal vascular alterations have been observed in various systemic conditions, but their presence in MIS-C is not well-established.
- Optical coherence tomography angiography (OCTA) offers a non-invasive method to assess retinal microvasculature.
Purpose of the Study:
- To investigate potential retinal vascular changes using OCTA in children diagnosed with MIS-C.
- To compare OCTA findings in MIS-C patients with those of pediatric COVID-19 patients and healthy controls.
- To evaluate relatively long-term (6 months post-diagnosis) ocular outcomes in MIS-C.
Main Methods:
- A cross-sectional study involving 21 MIS-C patients, 20 pediatric COVID-19 patients, and 26 healthy children.
- All participants underwent comprehensive ophthalmologic examinations and OCTA.
- OCTA parameters analyzed included vascular density of superficial, deep, and radial peripapillary capillary plexuses, foveal avascular zone (FAZ) metrics, and outer retinal/choriocapillaris flow areas.
Main Results:
- No significant differences in ophthalmologic examination findings were observed across the three groups.
- While some vascular density values were higher in the MIS-C group, these differences were not statistically significant compared to COVID-19 and control groups.
- FAZ parameters and outer retinal/choriocapillaris flow areas showed no statistically significant variations among the groups.
Conclusions:
- This study is the first to assess long-term OCTA outcomes in pediatric MIS-C and COVID-19 patients concurrently.
- No significant changes in superficial and deep capillary plexus parameters were detected in the pediatric MIS-C group at 6 months post-diagnosis.
- The findings suggest that ocular hemodynamic changes, if present, may not be detectable by OCTA 6 months after MIS-C or COVID-19 in children.
Purpose:
To evaluate retinal vascular changes by optical coherence tomography angiography (OCTA) in multisystem inflammatory syndrome in children (MIS-C).
Methods:
This cross-sectional study included 21 patients who were diagnosed with MIS-C and had a history of hospitalization, 20 pediatric outpatients with a coronavirus disease 2019 (COVID-19) diagnosis, and 26 healthy children. All patients underwent a detailed ophthalmologic examination and OCTA. In the MIS-C and pediatric COVID-19 groups, these evaluations were made 6 months after diagnosis. The vascular density values of the superficial, deep, and radial peripapillary capillary plexuses (SCP, DCP, and RPCP, respectively), foveal avascular zone (FAZ) parameters (area, perimeter, acircularity index, and foveal density), and outer retinal and choriocapillaris flow area values were recorded using OCTA.
Results:
No pathology was detected in the ophthalmologic examinations of the three groups with similar age and gender distributions. Although the vascular density values of SCP, DCP, and RPCP were found to be higher in most quadrants in the MIS-C group, there was no statistically significant difference among the three groups ( P > 0.05 for all). FAZ parameters and flow area measurements were similar in all three groups ( P > 0.05 for all).
Conclusion:
This is the first study to evaluate relatively long-term outcomes in patients with MIS-C and pediatric COVID-19 together. This study shows no changes in the SCP and DCP parameters in pediatric age group, which shows that ocular hemodynamic changes may not be reflected on OCTA after 6 months.
