Evaluation of the relationship between clinical parameters and retinal microvascular structures in children with...

This study aimed to evaluate retinal structural and microvascular changes in children with atopic dermatitis (AD) using optical coherence tomography (OCT) and OCT angiography (OCTA) and to analyze their associations with disease severity, comorbidities, corticosteroid use, and IgE levels.

A prospective, cross-sectional case-control study included 43 children with AD and 32 age- and sex-matched healthy controls. Peripapillary retinal nerve fiber layer (RNFL) and macular ganglion cell layer (GCL) thicknesses were measured by spectral-domain OCT. Retinal microvasculature was assessed by OCTA with 6×6mm macular scans. Vascular densities in superficial and deep capillary plexuses and choriocapillaris were calculated using the ETDRS grid. Clinical data included SCORAD scores, serum IgE, skin hydration, eosinophil counts, and duration of corticosteroid use.

Children with AD showed significantly reduced superior and temporal RNFL thickness compared with controls (P<0.05). Central and superior GCL thicknesses were lower but not significantly so. Foveal vascular density of the superficial plexus was significantly reduced in AD (18.7±3.3% vs. 20.4±3.4%, P=0.039). Correlation analyses showed superior RNFL thickness positively associated with skin hydration, whereas inferior GCL thickness correlated negatively. Longer corticosteroid use correlated with increased foveal superficial and superior deep vascular density, while serum IgE correlated positively with superior deep density and negatively with nasal density.

Pediatric AD may be linked to selective RNFL thinning and subtle macular vascular alterations, reflecting systemic inflammation. OCT and OCTA may serve as biomarkers for monitoring severity and early ocular involvement, underscoring the importance of interdisciplinary care.