Ocular morbidity among children with protein energy malnutrition in Northwest Nigeria

Abstract

Background: Protein energy malnutrition (PEM) remains a major health challenge in Nigeria, especially Northern Nigeria. Its association with ocular morbidity and irreversible blindness has been previously documented. There are however limited recent literature on these ocular manifestations, which may have evolved over the years. This study is thus relevant to establish a current baseline for the ocular manifestations associated with PEM in Northern Nigeria. Materials and Methods: This was a comparative, cross-sectional study. The sample size was 400 children; 200 with PEM, and 200 without PEM. Consenting parents with children between 6 – 59 months of age diagnosed with PEM, and those without PEM were recruited. Sociodemographic characteristics, general and ocular history were documented. A detailed ocular examination which included visual acuity assessment, examination of ocular adnexae, as well as the anterior and posterior segment of the eyes were done. Data was collected in a structured proforma, and analysed with the SPSS version 21, and Windows WinPepi softwares. Results: Abnormal ocular findings were significantly higher in the PEM group compared to the non-malnourished group [46.5% vs 24%, OR = 2.910 (1.891, 4.477), p = < 0.001]. The predominant ocular examination findings in the PEM and non-malnourished groups were infective conjunctivitis (35.5% vs 17%), lid oedema (11% vs 0%), signs of xerophthalmia (6% vs 0%) and visual impairment (3% vs 0%) Conclusion: PEM is still complicated by varying severity of ocular morbidity, with the potential of progression to irreversible blindness.

Comparison of retinal nerve fiber layer thickness between malnourished and healthy children using spectral domain optical coherence tomography.

“…Malnutrition is a critical global health issue, particularly affecting children, and its systemic impact on various organ systems, including the eyes, has been recognized. [5][6][7] Our results revealed reduced RNFL thickness in malnourished children when compared to healthy children. These observations suggest that malnutrition may be linked with alterations in the structural integrity of the RNFL.…”

“…micronutrients involve ocular surface impairment as a result of riboflavin deficiency, nystagmus related to thiamine deficiency, optic atrophy stemming from copper or B12 deficiencies, occurrences of strabismus, macular degeneration, thinning of the RNFL, and reduction in the thickness of this layer due to iron deficiency. 6,7 According to a study, malnutrition reportedly leads to cortical thinning, reduced neuron count and myelination. 8 To examine the effect of malnutrition on choroid, SD-OCT can be used to observe the vascular structure supplying micronutrients and oxygen to the outer retina.…”