The evaluation of retinal nerve fiber layer in children with vitamin B12 deficiency

Purpose: To evaluate the peripapiller retinal nerve fiber layer (RNFL) thickness with spectral domain optical coherence tomography (SD-OCT) in pediatric cases who presented with different neurological symptoms and determined with vitamin B12 deficiency. Materials and Methods: Twenty-six patients diagnosed with vitamin B12 deficiency (study group) and 30 age and sex matched healthy children (control group) were included in this study. Complete blood count, serum vitamin B12 level (pg /mL), serum folic acid level (ng/ mL) and complete biochemical parameters were obtained for all subjects in both groups. Peripapillary RNFL thickness measurements were performed with SD-OCT (Optovue Inc. Fremont, CA, USA). Results: In comparison with the control group values, the superior RNFL and global RNFL thickness measurements of the study group were statistically significantly lower, indicating a thinner layer (p=0.01, p=0.007, respectively). The nasal and inferior RNFL thickness measurements of the study group were lower than those of the control group, however, no statistically significant difference was determined (p=0.069, p=0.097, respectively) Conclusions: RNFL thickness should be evaluated in children suffer from weakness, dizziness and numbness in the hands and feet and detected low serum vitamin b 12 level. Low RNFL values in these patients may be a direct / indirect indicator of central nervous system involvement.