Ocular Microstructural Alterations in Children With Spina Bifida: An Optical Coherence Tomography Study

To investigate microstructural alterations in the retina, choroid, and optic nerve head in children with spina bifida using optical coherence tomography.

Thirty-eight children with spina bifida and 32 children without spina bifida were included in this cross-sectional study. Both groups were matched for age and sex. Comprehensive ophthalmological examinations included optical coherence tomography imaging of the macula, choroid, and peripapillary retinal nerve fiber layer.

The mean age was 10.2 ± 3.5 years. Axial length was significantly shorter in patients with spina bifida (P = .025), and hyperopia was more frequent (P < .001). Central macular thickness was similar between the two groups (P = .553). However, single retinal layer analysis revealed significant differences. In patients with spina bifida, the outer nuclear layer was thicker (P = .019) and the inner nuclear and outer plexiform layers were thinner (P = .038, P = .035). Subfoveal and nasal choroidal thicknesses were greater in patients with spina bifida (P = .012, P = .038). However, there was no significant difference in choroidal thickness after comparing the two groups by controlling the axial length variable.

Children with spina bifida may have retinal and choroidal alterations detectable with optical coherence tomography. Choroidal changes may be related to shorter axial length, whereas retinal alterations could reflect impaired macular development in spina bifida.