Assessment of the Choroidal Vascular Structure in Multisystem Inflammatory Syndrome in Children

Abstract

Purpose: To evaluate the choroidal vascular structure in cases of multisystem inflammatory syndrome in children (MIS-C). Methods: This prospective study included 38 eyes of 19 patients with MIS-C and 60 eyes of 30 healthy participants. Optical coherence tomography (OCT) imaging was performed at 1 month after diagnosis in the MIS-C group. Using enhanced depth imaging OCT, choroidal thickness was measured in the subfoveal, nasal, and temporal quadrants at 500 and 1,500 µm distances from the fovea (SCT, N 500 CT, T 500 CT, N 1500 CT, and T 1500 CT, respectively). The luminal, stromal, and total choroidal areas were evaluated with the binarization method in ImageJ software (National Institutes of Health). The ratio of the luminal area to the total choroidal area was determined as the choroidal vascular index (CVI). Results: The age and sex distributions of the two groups without any ophthalmologic pathology were similar ( P > .05). The choroidal thickness values in all quadrants except for T 1500 CT were similar between the two groups ( P > .05). T 1500 CT was significantly lower in the MIS-C group ( P = .02). The luminal choroidal area was 1.04 ± 0.10 mm 2 in the MIS-C group and 1.26 ± 0.24 mm 2 in the healthy control group ( P < .001), and the CVI values were 0.52 ± 0.04 and 0.57 ± 0.09, respectively ( P = .01). The stromal and total choroidal area values did not significantly differ between the two groups ( P > .05). Conclusions: This is the first study to evaluate CVI in patients with MIS-C. It was observed that the choroidal vascular structure could be affected in the early period of MIS-C, as shown by a decrease in the CVI value and luminal vascular area. OCT can be used to monitor ocular vascular changes in these patients. [ J Pediatr Ophthalmol Strabismus . 20XX;X(X):XX–XX.]