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    Choroidal thickness and choroidal vascular index in childhood malnutrition
    (Elsevier Science Inc, 2025) Sukun, Elmas Yuksel; Yavrum, Fuat; Yavrum, Begum
    Objectives: Malnutrition is a global health issue affecting growth and systemic health in children, yet its impact on the choroid-a vascular layer essential for retinal nourishment-remains underexplored. This study evaluates the choroidal vascular index (CVI) and choroidal thickness in malnourished children compared to healthy controls using optical coherence tomography (OCT). It also examines the relationship between these parameters and nutritional markers, including serum ferritin, vitamin B12, vitamin D, and hemoglobin levels. Methods: This cross-sectional study involved 52 malnourished and 40 healthy children aged 6-16 years. Malnutrition severity was categorized as mild, moderate, or severe based on WHO BMI criteria. Choroidal parameters were measured using spectral-domain optical coherence tomography (SD-OCT). Statistical analysis compared CVI and thickness between groups and assessed correlations with malnutrition severity and nutritional markers. Results: CVI was significantly lower in malnourished children compared to controls (P < 0.05), while choroidal thickness showed no significant difference (P > 0.05). CVI negatively correlated with malnutrition severity (r = -0.45, P < 0.01). Ferritin and vitamin D levels were positively associated with CVI (P < 0.001), whereas vitamin B12 showed no significant relationship. Lower hemoglobin levels were linked to vascular compromise. Conclusions: Malnutrition adversely affects CVI, even in early stages, suggesting it as a marker of choroidal vascular compromise. Micronutrients, particularly ferritin and vitamin D, appear protective. Monitoring choroidal parameters and addressing nutritional deficiencies may help prevent ocular complications in malnourished children. (c) 2025 Elsevier Inc. All rights are reserved, including those for text and data mining, AI training, and similar technologies.
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    Impact of malnutrition on pupillary responses in pediatric population
    (Sage Publications Ltd, 2026) Kocabas, Dilara Ozkoyuncu; Yavrum, Fuat; Sukun, Elmas Yuksel; Yavrum, Begum
    Purpose : To investigate the effect of nutritional status on pupillary responses in children aged 5 to 18 years. Methods : This cross-sectional study comprised 92 eyes of malnourished children and 80 eyes of age- and gender-matched healthy children based on BMI Z-score. Serum ferritin, hemoglobin, serum 25-hydroxyvitamin D, and vitamin B12 levels were recorded. Pupillary responses were taken using Sirius topography (CSO, Italy) with the automated pupillometry function. Static pupillometry consisted of pupil diameters at scotopic, mesopic, and photopic luminances. In dynamic pupillometry, the mean pupil dilation speed at the 10th second was calculated by dividing the distance by time in each 0.2 s period. Results : No significant difference was observed between the groups regarding age, gender, visual acuity, and spherical equivalent (p > 0.05). Mean hemoglobin, serum ferritin, serum 25-hydroxyvitamin D, and vitamin B12 levels were lower in malnourished children than healthy children (p < 0.001). The malnutrition group had lower mean pupil diameters under all luminance and higher speed of pupil dilation compared to the control group (p < 0.05). While malnutrition subgroups were similar in terms of pupil diameters under all luminance (p > 0.05), the speed of pupil dilation was significantly different between the groups (p = 0.024). BMI z-score was positively correlated with mesopic and photopic pupil diameter but also negatively correlated with the speed of pupil dilation (p < 0.05). Conclusion : Malnourished children have smaller pupil diameters and higher speed of pupil dilation than healthy controls, indicating an autonomic impairment.