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

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

METHODS

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.

RESULTS

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).

CONCLUSIONS

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.