Comparison of retinal nerve fiber layer thickness between malnourished and healthy children using spectral domain optical coherence tomography.

Objective: To compare the retinal nerve fiber layer (RNFL) thickness between malnourished and healthy children using Spectral Domain Optical Coherence Tomography (SD-OCT). Study Design: Cross-sectional study. Setting: Department of Pediatrics, National Institute of Child Health and The Hashmani’s Hospital, Karachi, Pakistan. Period: January 2023 to June 2023. Material & Methods: Twenty-two malnourished children of either gender, aged between 5-12 years, with no ocular findings, and another 22 healthy children of either gender with relatively similar age, with no ocular findings were enrolled. Anthropometric measurements including height and weight were performed and Z-score were calculated. All participants underwent a comprehensive eye examination. The SD-OCT was employed to record thickness of the RNFL. Results: In a total of 44 children, there were 22 (50.0%) boys and 22 (50.0%) girls. The mean age was 9.30±2.93 years (ranging between 5 to 12 years). The mean BMI Z-score was -1.01±2.11. Intraocular pressure was significantly reduced in children with malnutrition (p<0.001). Children with malnutrition were having significantly decreased superonasal (110.27±19.26 vs. 125.32±17.49, p=0.010), and infernonasal (112.86±21.04 vs. 132.00±31.53, p=0.023) RNFL. Correlation of body mass index (BMI) Z-Scores with parameters of RNFL thickness showed a significantly positive relationship with global scores (p=0.031). Conclusion: Our study using SD-OCT revealed that malnourished children exhibited decreased thickness of RNFL compared to healthy children. Furthermore, there was a positive relationship between BMI Z-scores and global RNFL thickness scores.