Evaluation of Long-term Posterior Segment Parameters in Children Who Had Recovered From Multisystem Inflammatory Syndrome

Ophthalmic Surg Lasers Imaging Retina. 2024 Sep;55(9):518-526. doi: 10.3928/23258160-20240415-01. Epub 2024 Jun 1.

Abstract

Background and objective: To evaluate long-term posterior segment findings in children recovering from multisystemic inflammatory syndrome (MIS-C) associated with severe acute respiratory syndrome coronavirus 2.

Patients and methods: Our study included 22 patients who were admitted to an intensive care unit with a diagnosis of MIS-C between November 2021 and March 2022, and 25 healthy controls. The study included pediatric patients who had an eye examination an average of 12.35 ± 2.18 months after recovery from MIS-C. Detailed eye examinations and measurements of all participants were obtained retrospectively from patient files. Posterior segment parameters were measured using swept-source optical coherence tomography (OCT) and OCT-angiography (OCT-A); these parameters included peripapillary retinal nerve fiber layer (pRNFL) thickness, central macular thickness (CMT), subfoveal choroidal thickness (SCT), macular vascular densities (VD), and foveal avascular zone (FAZ) area.

Results: Mean age was 9.7 ± 3.6 years in the MIS-C group and 10.6 ± 2.8 years in the healthy control group (P = 0.316). There were no statistically significant differences between the MIS-C group and the healthy control group in terms of pRNFL thickness, CMT, and SCT. However, in the MIS-C group, the macular superficial vascular plexus and deep vascular plexus showed significantly lower VD in the superior, inferior, nasal, and temporal quadrants compared to the healthy controls (P < 0.05 for all). A comparison of the superficial and deep FAZ area parameters of both groups showed no statistically significant difference (P > 0.05).

Conclusions: We showed that patients who had recovered from MIS-C had retinal vascular damage at the long-term follow-up. Following up with these patients after recovery with OCT and OCT-A, which are noninvasive methods commonly used in the detailed evaluation of the posterior segment of the eye, could be beneficial for understanding the long-term effects of MIS-C on retinal microvasculature. [Ophthalmic Surg Lasers Imaging Retina 2024;55:518-526.].

MeSH terms

  • Adolescent
  • COVID-19* / complications
  • Child
  • Child, Preschool
  • Female
  • Fluorescein Angiography* / methods
  • Follow-Up Studies
  • Fundus Oculi
  • Humans
  • Macula Lutea / diagnostic imaging
  • Macula Lutea / pathology
  • Male
  • Nerve Fibers / pathology
  • Posterior Eye Segment / diagnostic imaging
  • Posterior Eye Segment / pathology
  • Retinal Ganglion Cells / pathology
  • Retinal Vessels / diagnostic imaging
  • Retinal Vessels / pathology
  • Retrospective Studies
  • SARS-CoV-2*
  • Systemic Inflammatory Response Syndrome* / diagnosis
  • Tomography, Optical Coherence* / methods
  • Visual Acuity

Supplementary concepts

  • pediatric multisystem inflammatory disease, COVID-19 related