Long-Term Foveal Microvascular Alterations in Children With Hypoxic-Ischemic Encephalopathy: An OCT Angiography Study

To investigate the foveal microvascular structure in children with a history of hypoxic ischemic encephalopathy (HIE) compared with healthy controls.

This prospective cross-sectional comparative study included 46 eyes of 23 children with HIE and 40 eyes of 20 age-matched healthy controls. The children were grouped as follows: Group 1: HIE Stage I (n=28 eyes); Group 2: HIE Stage II-III (n=18 eyes); Group 3: healthy age-matched controls (n=40 eyes). Patients were also subgrouped based on fundus appearance within the first week of life as follows: Group A: eyes without any retinal hemorrhages (RHs) (n=13 eyes); Group B: eyes with widespread peripheral RHs sparing the macula (n=28 eyes); Group C: eyes with widespread peripheral RHs with macular involvement (n=5 eyes); Group D: healthy controls (n=40 eyes). All children underwent optical coherence tomography angiography (OCTA)(Solix Visionix). FAZ area, foveal vessel densities and central foveal thickness (CFT) were compared.

Foveal vessel density of the superficial capillary plexus (VD-SCP) and CFT were significantly higher in Group 2 compared with Group 1 (all p<0.05). Significantly smaller FAZ area was noted in Group 2 (0.19±0.09 mm2) compared with Group 1 (0.28±0.10 mm2) and 3 (0.26±0.09 mm2)(all p<0.05).

HIE may lead to persistent alterations in foveal microvasculature. OCTA may serve as a non-invasive biomarker for detecting long-term retinal microvascular sequelae in children with a history of perinatal asphyxia.