Choroidal thickness and choroidal vascular index in childhood malnutrition

Abstract

Objectives: Malnutrition is a global health issue affecting growth and systemic health in children, yet its impact on the choroid-a vascular layer essential for retinal nourishment-remains underexplored. This study evaluates the choroidal vascular index (CVI) and choroidal thickness in malnourished children compared to healthy controls using optical coherence tomography (OCT). It also examines the relationship between these parameters and nutritional markers, including serum ferritin, vitamin B12, vitamin D, and hemoglobin levels.

Methods: This cross-sectional study involved 52 malnourished and 40 healthy children aged 6-16 years. Malnutrition severity was categorized as mild, moderate, or severe based on WHO BMI criteria. Choroidal parameters were measured using spectral-domain optical coherence tomography (SD-OCT). Statistical analysis compared CVI and thickness between groups and assessed correlations with malnutrition severity and nutritional markers.

Results: CVI was significantly lower in malnourished children compared to controls (P < 0.05), while choroidal thickness showed no significant difference (P > 0.05). CVI negatively correlated with malnutrition severity (r = -0.45, P < 0.01). Ferritin and vitamin D levels were positively associated with CVI (P < 0.001), whereas vitamin B12 showed no significant relationship. Lower hemoglobin levels were linked to vascular compromise.

Conclusions: Malnutrition adversely affects CVI, even in early stages, suggesting it as a marker of choroidal vascular compromise. Micronutrients, particularly ferritin and vitamin D, appear protective. Monitoring choroidal parameters and addressing nutritional deficiencies may help prevent ocular complications in malnourished children.

Keywords: Choroidal thickness; Choroidal vascular index; Malnutrition; Microcirculation; Pediatric population.