Assessment of peripapillary retinal nerve fiber layer ...

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May 16, 2013 - macrobiotic diet as children, even when they consumed a meat-based diet after 6 years [18]. The results point to the importance of vitamin B12 ...
Childs Nerv Syst (2013) 29:2281–2286 DOI 10.1007/s00381-013-2138-0

ORIGINAL PAPER

Assessment of peripapillary retinal nerve fiber layer thickness in children with vitamin B12 deficiency Serdar Özkasap & Kemal Türkyilmaz & Selim Dereci & Veysi Öner & Tuğba Calapoğlu & Medine Cumhur Cüre & Mustafa Durmuş

Received: 19 March 2013 / Accepted: 29 April 2013 / Published online: 16 May 2013 # Springer-Verlag Berlin Heidelberg 2013

Abstract Purpose Vitamin B12 deficiency is a worldwide problem. It affects all ages, including children. It is one of the most common nutritional disorders and can cause harmful effects on the nervous system. In this study, we compared the peripapillary retinal nerve fiber layer thickness (RNFLT) in a healthy control group with children with vitamin B12 deficiency. In our study, we aimed to evaluate the effect of vitamin B12 deficiency on the RNFLT in children with the optical coherence tomography (OCT) method. Methods Sixty-six children with a diagnosis of vitamin B12 deficiency (patient group) and 66 age- and sex-matched healthy children (control group) were enrolled in this prospectively designed study. Blood counts, vitamin B12 levels, folate levels, and full biochemical parameters were obtained for all the subjects in each group. Peripapillary RNFLT measurements were performed with Cirrus HD spectral domain OCT. Results The thickness of the superior retinal nerve fiber layer (RNFL) in the vitamin B12 deficiency group was significantly lower than that of the control group (p=0.037). Although the average thickness of the RNFL was lower in the patient group, there was no statistically significant differences (p=0.216). In S. Özkasap (*) Faculty of Medicine, Division of Pediatric Hematology and Oncology, Recep Tayyip Erdogan University, Rize, Turkey e-mail: [email protected] K. Türkyilmaz : V. Öner : M. Durmuş Faculty of Medicine, Department of Ophthalmology, Recep Tayyip Erdogan University, Rize, Turkey S. Dereci : T. Calapoğlu Faculty of Medicine, Department of Pediatrics, Recep Tayyip Erdogan University, Rize, Turkey M. C. Cüre Faculty of Medicine, Department of Biochemistry, Recep Tayyip Erdogan University, Rize, Turkey

the vitamin B12 deficiency group, the average RNFL thickness and the superior RNFL thickness were significantly correlated with vitamin B12 levels (r1 =0.353, p1 6.0 diopters, and any other systemic disease other than vitamin B12 deficiency. Patients who had been born prematurely were also excluded. The peripapillary RNFLT measurements were performed with a Cirrus HD spectral domain OCT (Carl Zeiss Meditec, Dublin, CA) by the same blinded investigator. The peripapillary RNFLT of the temporal, nasal, inferior, and superior quadrants and the average thickness of the RNFL were obtained with the optic disk 200×200 cube scan protocol along a circle with a diameter of 3.45 mm around the center of the disk. Scans that had signal strengths