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Evaluation of posterior segment changes in pediatric asthma patients with and without inhaled corticosteroid therapy
Ulviye Kıvrak1,2, Fatih Çiçek3, Mehmet Tolga Köle4
1Department of Ophthalmology, Kartal Dr Lütfi Kırdar City Hospital University of Health Sciences, Cevizli, D-100 Güney Yanyol, Cevizli Mevkii No:47, 34865, Kartal, Istanbul, Turkey. dr.ulviyekivrak@hotmail.com.
Insights
Pediatric asthma patients show reduced posterior segment vascularity and choroidal thickness, potentially linked to inflammation and hypoxia. Early detection via optical coherence tomography (OCT) and OCT angiography (OCTA) aids in preserving vision.
Area of Science:
- Ophthalmology
- Pediatric Pulmonology
- Medical Imaging
Background:
- Asthma is a chronic inflammatory condition affecting children, with potential systemic implications.
- Inhaled corticosteroids are a common treatment for pediatric asthma.
- The posterior segment of the eye, including retinal vasculature and choroid, may be affected by systemic inflammation and hypoxia.
Purpose of the Study:
- To evaluate and compare posterior segment changes in pediatric asthma patients.
- To investigate potential associations between asthma, inhaled corticosteroid use, and ocular microvasculature.
- To assess the utility of optical coherence tomography (OCT) and OCT angiography (OCTA) in pediatric asthma research.
Main Methods:
- Retrospective analysis of pediatric patients (7-17 years) with atopic asthma.
- Categorization into groups: no inhaled corticosteroids, inhaled corticosteroid treatment, and healthy controls.
- Collection of demographic, clinical, and laboratory data (eosinophil count, IgE, CRP).
- Assessment of posterior segment parameters using OCT and OCTA.
Main Results:
- Asthma patients exhibited significantly reduced subfoveal choroidal thickness compared to controls.
- Reductions were observed in superficial capillary plexus and choriocapillaris density in asthma patients.
- Peripapillary vascular density was significantly lower in the inferior and superior quadrants of asthma patients.
- Inflammation markers (eosinophil count, CRP) correlated with changes in vascular density.
Conclusions:
- Asthma, as an inflammatory and hypoxic condition, significantly impacts posterior segment parameters in children.
- Microvascular changes in the retina and choroid may occur in pediatric asthma patients.
- OCT and OCTA are valuable tools for detecting early microvascular alterations and informing visual health interventions.
Abstract:
This study aimed to evaluate and compare changes in the posterior segment of pediatric asthma patients, potentially associated with asthma or inhaled corticosteroids. A retrospective analysis was conducted on children aged 7-17 diagnosed with atopic asthma. The participants were categorized into groups: Group 1 (no inhaled corticosteroids) and Group 2 (inhaled corticosteroid treatment). A control group of healthy children was also included. Demographic data, clinical findings, and laboratory results (e.g., eosinophil count, IgE, CRP levels) were collected. Optical coherence tomography (OCT) and OCT angiography (OCTA) were used to measure posterior segment parameters. Asthma patients demonstrated a statistically significant reduction in subfoveal choroidal thickness, the superficial capillary plexus in the superior and nasal quadrants, the choriocapillaris in the foveal quadrant, and the peripapillary vascular density in the inferior and superior quadrants compared to controls. Inflammation markers such as eosinophil count and CRP showed significant correlations with changes in vascular density. Asthma, as a chronic inflammatory and hypoxic condition, can significantly affect posterior segment parameters, leading to potential visual function impairments in children. Regular monitoring with OCT and OCTA can help detect early microvascular changes, allowing for timely interventions to preserve visual health.
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