Dyslipidemia and Retinal Microvascular Health in Children and Adolescents: A Systematic Review.

Background/Objectives: Dyslipidemia is increasingly linked to retinal microvascular changes, yet its impact in pediatric populations remains unclear. Given the retina's role as a microvascular model, this review evaluates the association between dyslipidemia and retinal vascular alterations in children and adolescents. Methods: We conducted a systematic review following the Preferred Reporting Items for Systematic Reviews and Meta-analysis (PRISMA) guidelines to evaluate the association between lipid profiles, body composition, and retinal vascular parameters in individuals younger than 19 years. Four eligible studies were found. Results: Triglyceride (TG) levels, total cholesterol (TC) levels, low-density lipoprotein cholesterol (LDL-C), and apolipoprotein B (apoB) levels were associated with smaller retinal arteriole diameters (CRAE), whereas there was no consistent association between venular diameter (CRVE) and lipid levels. In addition, families with familial hypercholesterolemia (FH) had lower capillary densities and larger foveal avascular zone areas detected by optical coherence tomography angiography (OCT-A) compared to control subjects. The presence of both obesity and dyslipidemia resulted in greater degrees of arteriolar narrowing. Conclusions: These findings suggest that adverse metabolic profiles in childhood may be linked to early microvascular alterations. However, the limited number of heterogeneous studies highlights the need for larger longitudinal investigations.