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Background <p>Childhood asthma is a chronic inflammatory and intermittently hypoxic condition that may exert systemic effects beyond the respiratory system. These processes may influence retinal and choroidal microvascular structures. Optical coherence tomography (OCT) and optical coherence tomography angiography (OCTA) allow non-invasive and quantitative evaluation of posterior segment neuronal and vascular structures. This study aimed to evaluate retinal and choroidal microvascular parameters in children with asthma without clinical ocular findings, to analyze differences according to inhaled corticosteroid (ICS) dose, and to compare the findings with healthy controls.</p> Methods <p>This cross-sectional study included 56 children with asthma and 30 age- and sex-matched healthy controls aged 5–18 years. Asthma diagnosis was established according to Global Initiative for Asthma (GINA) guidelines. Patients were categorized as low-dose or moderate-high-dose ICS users based on their treatment during the previous year. OCTA was used to measure vessel density (VD) in the superficial capillary plexus (SCP), deep capillary plexus (DCP), and choriocapillaris (CC), and OCT was used to measure central macular thickness (CMT). Group comparisons were performed. P values were corrected for multiple comparisons using the Benjamini-Hochberg false discovery rate (FDR) method. Discriminative parameters were evaluated using Receiver Operating Characteristic (ROC) analysis, and variables were included in univariate and multivariate logistic regression models.</p> Results <p>There were no significant differences between groups in terms of age and sex (<i>p</i> &gt; 0.05). Vessel density values in the SCP, DCP, and CC were significantly lower in the asthma group compared with controls across all quadrants (all FDR-corrected <i>p</i> &lt; 0.05). CMT was significantly thinner in asthmatic children (<i>p</i> &lt; 0.001). In multivariate analysis, nasal CC vessel density remained statistically significant (<i>p</i> &lt; 0.001). ROC analysis showed an area under the curve of 0.966 for nasal CC vessel density. In subgroup analysis according to ICS dose, no parameters remained statistically significant after FDR correction (all FDR-corrected <i>p</i> &gt; 0.05).</p> Conclusions <p>Asthma may be associated with subclinical posterior segment microvascular alterations. The absence of significant differences according to ICS dose after multiple comparison correction suggests that these changes are primarily related to the disease itself rather than treatment exposure. OCT and OCTA may contribute to early detection and follow-up.</p>

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Subclinical retinal and choroidal microvascular involvement in pediatric asthma: an OCTA-based analysis of corticosteroid exposure

  • 期刊论文

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  • 发表日期：

    2026年8月5日

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  • Guler Kilic,
  • Zuhal Karali

摘要

Background

Childhood asthma is a chronic inflammatory and intermittently hypoxic condition that may exert systemic effects beyond the respiratory system. These processes may influence retinal and choroidal microvascular structures. Optical coherence tomography (OCT) and optical coherence tomography angiography (OCTA) allow non-invasive and quantitative evaluation of posterior segment neuronal and vascular structures. This study aimed to evaluate retinal and choroidal microvascular parameters in children with asthma without clinical ocular findings, to analyze differences according to inhaled corticosteroid (ICS) dose, and to compare the findings with healthy controls.

Methods

This cross-sectional study included 56 children with asthma and 30 age- and sex-matched healthy controls aged 5–18 years. Asthma diagnosis was established according to Global Initiative for Asthma (GINA) guidelines. Patients were categorized as low-dose or moderate-high-dose ICS users based on their treatment during the previous year. OCTA was used to measure vessel density (VD) in the superficial capillary plexus (SCP), deep capillary plexus (DCP), and choriocapillaris (CC), and OCT was used to measure central macular thickness (CMT). Group comparisons were performed. P values were corrected for multiple comparisons using the Benjamini-Hochberg false discovery rate (FDR) method. Discriminative parameters were evaluated using Receiver Operating Characteristic (ROC) analysis, and variables were included in univariate and multivariate logistic regression models.

Results

There were no significant differences between groups in terms of age and sex (p > 0.05). Vessel density values in the SCP, DCP, and CC were significantly lower in the asthma group compared with controls across all quadrants (all FDR-corrected p < 0.05). CMT was significantly thinner in asthmatic children (p < 0.001). In multivariate analysis, nasal CC vessel density remained statistically significant (p < 0.001). ROC analysis showed an area under the curve of 0.966 for nasal CC vessel density. In subgroup analysis according to ICS dose, no parameters remained statistically significant after FDR correction (all FDR-corrected p > 0.05).

Conclusions

Asthma may be associated with subclinical posterior segment microvascular alterations. The absence of significant differences according to ICS dose after multiple comparison correction suggests that these changes are primarily related to the disease itself rather than treatment exposure. OCT and OCTA may contribute to early detection and follow-up.