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Pétursdóttir D, Åkerblom H, Holmström G, Larsson E. Central macular morphology and optic nerve fibre layer thickness in young adults born premature and screened for retinopathy of prematurity. Acta Ophthalmol 2023. [PMID: 37991127 DOI: 10.1111/aos.15814] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/10/2023] [Revised: 10/08/2023] [Accepted: 11/06/2023] [Indexed: 11/23/2023]
Abstract
PURPOSE To investigate central retinal morphology and optic retinal nerve fibre layer (RNFL) in prematurely born young adults and compare to term born controls. MATERIALS AND METHODS The participants were 59 prematurely born individuals, with a birthweight ≤1.500 g, and 44 term born controls, all 25-29 years of age. Visual acuity (VA) and contrast sensitivity (CS) were assessed. The retinal macular thickness, ganglion cell-inner plexiform layer (GC-IPL) thickness and RNFL thickness were assessed with Cirrus optical coherence tomography (OCT). RESULTS Central macular thickness was increased (mean 26.7 μm) in prematurely born individuals compared to controls. The macular GC-IPL was thinner (mean 3.84 μm), also when excluding those with previous retinopathy of prematurity (ROP) and those with neurological complications. Gestational age at birth and previous treatment of ROP were risk factors for a thicker macula, however, not for reduced GC-IPL. The average peripapillary RNFL was thinner (mean 4.61 μm) in the prematurely born individuals, also when excluding those with previous ROP and/or neurological complications. Within the prematurely born group, treated ROP was correlated with increased average RNFL. Further, both better VA and CS were associated with thinner optic nerve RNFL and thicker average GC-IPL. CONCLUSION Macular and optic nerve morphology were influenced by premature birth as assessed with OCT in adult individuals. Gestational age at birth and treatment for ROP seemed to affect central macular thickness, and treated ROP affected the peripapillary RNFL. Thus, retinal sequelae remained in adulthood.
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Affiliation(s)
- Dýrleif Pétursdóttir
- Department of Surgical Sciences/Ophthalmology, Uppsala University, Uppsala, Sweden
- Department of Ophthalmology, Faculty of Medicine, National University Hospital, University of Iceland, Reykjavík, Iceland
| | - Hanna Åkerblom
- Department of Surgical Sciences/Ophthalmology, Uppsala University, Uppsala, Sweden
- Centre for Clinical Research Västmanland, Hospital of Västmanland, Västerås, Sweden
| | - Gerd Holmström
- Department of Surgical Sciences/Ophthalmology, Uppsala University, Uppsala, Sweden
| | - Eva Larsson
- Department of Surgical Sciences/Ophthalmology, Uppsala University, Uppsala, Sweden
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2
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Wenner Y, Kunze K, Lazaridis A, Brauer V, Besgen V, Davidova P, Sekundo W, Maier RF. The impact of perinatal brain injury on retinal nerve fiber layer thickness and optic nerve head parameters of premature children. Graefes Arch Clin Exp Ophthalmol 2023; 261:2701-2707. [PMID: 37119306 PMCID: PMC10432335 DOI: 10.1007/s00417-023-06069-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/14/2022] [Revised: 03/14/2023] [Accepted: 04/11/2023] [Indexed: 05/01/2023] Open
Abstract
PURPOSE This study aims to evaluate the impact of birth weight (BW), gestational age (GA), retinopathy of prematurity (ROP), and perinatal brain injury (PBI) on optic nerve head (ONH) parameters and nerve fiber layer thickness (RNFLT) in preterm children. METHODS ONH parameters and RNFLT were examined prospectively in 5-15-year-old preterm and full-term children with RTVue-100 OCT (Optovue, USA). The parameters of the two groups were compared and possible influences of BW, GA, ROP, and PBI analyzed in preterm children. RESULTS In total, 51 full-term and 55 preterm children were included. The mean age was 9.98 ± 3.4 years in full-term and 10.0 ± 2.5 years in preterm children. The mean GA in preterm children was 29.6 ± 3.8 weeks with a BW of 1523 ± 732 g. RNFLT was significantly lower in preterm than in full-term children in all but temporal quadrants. Cup area, volume, cup/disc area ratio, and horizontal cup/disc ratio (CDR) were significantly larger and rim area significantly thinner in preterm children. GA was positively correlated with superior, nasal, and overall RNFLT and negatively correlated with cup area, volume, and horizontal CDR. ROP stage correlated negatively with superior and nasal RNFLT. PBI was the only significant predicting factor for RNFL thinning in all but temporal quadrant in multiple regression analysis. Preterm children with PBI had a significantly larger optic cup (CDR 0.70 ± 0.33 vs. 0.37 ± 0.27) and thinner optic rim. CONCLUSION PBI correlated strongest with RNFL thinning, a thinner optic rim, and a larger optic cup in preterm children and should be evaluated in each patient to prevent incorrect diagnosis like glaucoma.
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Affiliation(s)
- Yaroslava Wenner
- Department of Ophthalmology, Philipps-University, Universitätsklinikum Giessen and Marburg GmbH, Marburg Campus, Marburg, Germany.
- Department of Ophthalmology, Goethe-University, Theodor-Stern-Kai 7, 60590, Frankfurt Am Main, Germany.
| | - Kira Kunze
- Department of Ophthalmology, Philipps-University, Universitätsklinikum Giessen and Marburg GmbH, Marburg Campus, Marburg, Germany
| | - Apostolos Lazaridis
- Department of Ophthalmology, Philipps-University, Universitätsklinikum Giessen and Marburg GmbH, Marburg Campus, Marburg, Germany
| | - Vanessa Brauer
- Department of Ophthalmology, Philipps-University, Universitätsklinikum Giessen and Marburg GmbH, Marburg Campus, Marburg, Germany
| | - Volker Besgen
- Department of Ophthalmology, Philipps-University, Universitätsklinikum Giessen and Marburg GmbH, Marburg Campus, Marburg, Germany
| | - Petra Davidova
- Department of Ophthalmology, Goethe-University, Theodor-Stern-Kai 7, 60590, Frankfurt Am Main, Germany
| | - Walter Sekundo
- Department of Ophthalmology, Philipps-University, Universitätsklinikum Giessen and Marburg GmbH, Marburg Campus, Marburg, Germany
| | - Rolf F Maier
- Department of Paediatrics, Philipps-University, Universitätsklinikum Giessen and Marburg GmbH, Marburg Campus, Marburg, Germany
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Cheng H, Cao D, Qian J, Gu W, Zheng Z, Ma M. Refractive status and retinal morphology in children with a history of intravitreal ranibizumab for retinopathy of prematurity. Eur J Pediatr 2023:10.1007/s00431-023-04965-7. [PMID: 37097446 DOI: 10.1007/s00431-023-04965-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/10/2022] [Revised: 03/20/2023] [Accepted: 03/30/2023] [Indexed: 04/26/2023]
Abstract
This study investigated the characteristics of refractive status, visual acuity, and retinal morphology in children with a history of receiving intravitreal ranibizumab for retinopathy of prematurity (ROP). Children 4-6 years of age were enrolled and divided into the following four groups: group 1, children with a history of ROP who had been treated with intravitreal ranibizumab; group 2, children with a history of ROP who had not received any treatment; group 3, premature children without ROP; and group 4, full-term children. Refractive status, peripapillary retinal nerve fiber layer (RNFL), and macular thickness were measured. A total of 204 children were enrolled. In group 1, myopic shift was not noted, but poorer best corrected visual acuity (BCVA) and shorter axial length were observed. Significantly lower peripapillary RNFL thickness in the average total and superior quadrant, higher central subfield thickness, lower parafoveal retinal thickness in average total, superior, and nasal and temporal quadrants were observed in group 1 than in the other groups. The poor BCVA in patients with ROP was correlated with the lower RNFL thickness in the superior quadrant. Conclusion: Children with a history of type 1 ROP treated with ranibizumab did not show a myopic shift but did show abnormal retinal morphology and the poorest BCVA among all groups. We suggest that pediatric ophthalmologists should always pay attention to visual development in patients with ROP with a history of intravitreal ranibizumab. What is Known: • Anti-VEGF is efficiently and widely used in the treatment of type 1 retinopathy of prematurity (ROP), and different anti-VEGF agents are associated with different prevalence of myopia. • Patients with ROP who receive treatment such as laser therapy or cryotherapy have abnormal macular development and retinal nerve fiber layer (RNFL) thickness. What is New: • Children with a history of ROP treated with intravitreal ranibizumab did not show a myopic shift but did show poor BCVA at 4-6 years of age. • Abnormal macular morphology and lower peripapillary RNFL thickness were found in these children.
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Affiliation(s)
- Haixia Cheng
- Department of Ophthalmology, Children's Hospital of Nanjing Medical University, Nanjing, Jiangsu, China
- Department of Ophthalmology, Shanghai General Hospital of Nanjing Medical University, Shanghai, China
| | - Di Cao
- Department of Ophthalmology, Shanghai General Hospital of Nanjing Medical University, Shanghai, China
- Department of Ophthalmology, Wuxi Maternity and Child Health Care Hospital, Women's Hospital of Jiangnan University, Jiangnan University, Wuxi, Jiangsu, China
| | - Jing Qian
- Department of Ophthalmology, Children's Hospital of Nanjing Medical University, Nanjing, Jiangsu, China
| | - Wei Gu
- Department of Quality Management, Children's Hospital of Nanjing Medical University, Nanjing, Jiangsu, China
| | - Zhi Zheng
- Department of Ophthalmology, Shanghai General Hospital of Nanjing Medical University, Shanghai, China.
- Department of Ophthalmology, Shanghai General Hospital; National Clinical Research Center for Eye Diseases; Shanghai Key Laboratory of Ocular Fundus Diseases; Shanghai Engineering Center for Visual Science and Photomedicine; Shanghai Engineering Center for Precise Diagnosis and Treatment of Eye Diseases, No. 85, Wujin Road, Hongkou District, Shanghai, China.
| | - Mingming Ma
- Department of Ophthalmology, Shanghai General Hospital; National Clinical Research Center for Eye Diseases; Shanghai Key Laboratory of Ocular Fundus Diseases; Shanghai Engineering Center for Visual Science and Photomedicine; Shanghai Engineering Center for Precise Diagnosis and Treatment of Eye Diseases, No. 85, Wujin Road, Hongkou District, Shanghai, China.
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4
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Retinal and peripapillary vascular deformations in prematurely born children aged 4-12 years with a history of retinopathy of prematurity. Sci Rep 2023; 13:3130. [PMID: 36813874 PMCID: PMC9946928 DOI: 10.1038/s41598-023-30166-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/24/2022] [Accepted: 02/16/2023] [Indexed: 02/24/2023] Open
Abstract
In this study, foveal, parafoveal, peripapillary anatomical, and microvascular anomalies in prematurely born children aged 4-12 years with a history of retinopathy of prematurity (ROP) were evaluated. Seventy-eight eyes of 78 prematurely born children ([tROP]: ROP with laser treatment, [srROP]: spontaneously regressed ROP) and 43 eyes of 43 healthy children were included. Foveal and peripapillary morphological parameters (including ganglion cell and inner plexiform layer (GCIPL) thickness, peripapillary retinal nerve fiber layer (pRNFL) thickness) and vasculature parameters (including foveal avascular zone area, vessel density from superficial retinal capillary plexus (SRCP), deep retinal capillary plexus (DRCP), and radial peripapillary capillary (RPC) segments) were analyzed. Foveal vessel densities in SRCP and DRCP were increased and parafoveal vessel densities in SRCP and RPC segments vessel density were decreased in both ROP groups compared with those of control eyes. The best-corrected visual acuity was negatively correlated with pRNFL thickness in the tROP group. Refractive error was negatively correlated with vessel density of RPC segments in the srROP group. In children born preterm with a history of ROP, it was found that foveal, parafoveal, and peripapillary structural and vascular anomalies and redistribution were accompanied. These retinal vascular and anatomical structure anomalies showed close relationships with visual functions.
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Fieß A, Schäffler A, Mildenberger E, Urschitz MS, Wagner FM, Hoffmann EM, Zepp F, Pfeiffer N, Schuster AK. Peripapillary Retinal Nerve Fiber Layer Thickness in Adults Born Extremely, Very, and Moderately Preterm With and Without Retinopathy of Prematurity: Results From the Gutenberg Prematurity Eye Study (GPES). Am J Ophthalmol 2022; 244:88-97. [PMID: 35932823 DOI: 10.1016/j.ajo.2022.07.019] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/08/2022] [Revised: 07/19/2022] [Accepted: 07/19/2022] [Indexed: 01/30/2023]
Abstract
PURPOSE This study investigated whether prematurity and associated factors or prenatal growth restriction have long-term effects on the peripapillary retinal nerve fiber layer (pRNFL) in adulthood. DESIGN Retrospective cohort study. METHODS The Gutenberg Prematurity Eye Study (GPES) is a retrospective cohort study with a prospective ophthalmologic examination in Germany. Selected individuals born term and preterm (age 18-52 years) were examined with spectral-domain optical coherence tomography (SD-OCT) in adulthood, and perinatal medical charts were reviewed. The pRNFL thickness was measured using SD-OCT. Univariate and multivariable linear regression analyses were conducted to investigate associations between pRNFL and gestational age (GA; categorical), birth weight percentile (categorical), retinopathy of prematurity (ROP) occurrence, and treatment and other perinatal parameters with adjustment for age, sex, and spherical equivalent. RESULTS In total, 766 eyes of 406 preterm and full-term individuals were included (mean age 28.4 ± 8.6 years, 228 females). After adjustment for age, sex, and spherical equivalent, global pRNFL thinning was associated with moderate (GA = 33-36 wk, β = -4.68, P < .001), very (GA = 29-32 wk, β = -5.72, P < .001), and extreme (GA ≤ 28 wk, β = -8.69, P < .001) prematurity but not with low birth weight percentile (<25th percentile, P = .9) and ROP occurrence (P = .9) in multivariable analysis. ROP treatment was associated with increased pRNFL in the temporal sector (P = .002). Maternal smoking during pregnancy showed an association with pRNFL thinning (P = .07). CONCLUSION Our data indicate that the more preterm individuals are born the more pRNFL thinning occurs, whereas prenatal growth restriction and postnatal occurrence of ROP show less effects on pRNFL thickness. Furthermore, individuals with severe ROP with treatment but not lower ROP stages without treatment showed an increased temporal pRNFL thickness.
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Affiliation(s)
- Achim Fieß
- From the Department of Ophthalmology (A.F., A.S., F.M.W., E.M.H., N.P., A.K.S.), University Medical Center of the Johannes Gutenberg University Mainz, Mainz, Germany.
| | - Alina Schäffler
- From the Department of Ophthalmology (A.F., A.S., F.M.W., E.M.H., N.P., A.K.S.), University Medical Center of the Johannes Gutenberg University Mainz, Mainz, Germany
| | - Eva Mildenberger
- Division of Neonatology, Department of Pediatrics (E.M., F.Z.), University Medical Center of the Johannes Gutenberg University Mainz, Mainz, Germany
| | - Michael S Urschitz
- Division of Pediatric Epidemiology, Institute for Medical Biostatistics, Epidemiology and Informatics (M.S.U.), University Medical Center of the Johannes Gutenberg University Mainz, Mainz, Germany
| | - Felix M Wagner
- From the Department of Ophthalmology (A.F., A.S., F.M.W., E.M.H., N.P., A.K.S.), University Medical Center of the Johannes Gutenberg University Mainz, Mainz, Germany
| | - Esther M Hoffmann
- From the Department of Ophthalmology (A.F., A.S., F.M.W., E.M.H., N.P., A.K.S.), University Medical Center of the Johannes Gutenberg University Mainz, Mainz, Germany
| | - Fred Zepp
- Division of Neonatology, Department of Pediatrics (E.M., F.Z.), University Medical Center of the Johannes Gutenberg University Mainz, Mainz, Germany
| | - Norbert Pfeiffer
- From the Department of Ophthalmology (A.F., A.S., F.M.W., E.M.H., N.P., A.K.S.), University Medical Center of the Johannes Gutenberg University Mainz, Mainz, Germany
| | - Alexander K Schuster
- From the Department of Ophthalmology (A.F., A.S., F.M.W., E.M.H., N.P., A.K.S.), University Medical Center of the Johannes Gutenberg University Mainz, Mainz, Germany
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6
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Lehtonen T, Vesti E, Haataja L, Nyman A, Uusitalo K, Leinonen MT, Setänen S. Peripapillary retinal nerve fibre layer thickness and macular ganglion cell layer volume in association with motor and cognitive outcomes in 11-year-old children born very preterm. Acta Ophthalmol 2022; 101:342-348. [PMID: 36259094 DOI: 10.1111/aos.15266] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/11/2022] [Revised: 09/05/2022] [Accepted: 09/24/2022] [Indexed: 11/26/2022]
Abstract
PURPOSE The purpose of the study was to study the association between retinal parameters and motor and cognitive outcomes in children born very preterm. METHODS This study is part of a prospective cohort study of very preterm infants (birth weight ≤ 1500 grams/gestational age < 32 weeks). At 11 years of age, the ophthalmological assessment included a retinal optical coherence tomography (OCT) examination of the peripapillary retinal nerve fibre layer (PRNFL) and the macular ganglion cell layer (GCL). The motor performance was assessed with the Movement Assessment Battery for Children-Second Edition (Movement ABC-2), and the cognitive outcome with the Wechsler Intelligence Scale for Children-Fourth Edition (WISC-IV). RESULTS A total of 141 children were included. The mean (SD) average PRNFL was 95 μm (10.2 μm). The mean (SD) macular GCL volume was 0.34 mm3 (0.03 mm3 ). Higher PRNFL thickness associated with higher percentiles for total scores in the motor assessment (b = 0.5, 95% CI 0.1-0.8, p = 0.01) and higher macular GCL volume with higher scores in the cognitive assessment (b = 1.4, 95% CI 0.5-2.3, p = 0.002), also when adjusted for gender, birth weight z-score (birth weight in relation to gestational age) and major brain pathology at term. CONCLUSION The associations between higher average PRNFL thickness and better motor performance as well as higher macular GCL volume and better cognitive performance refer to more generalized changes in the brain of 11-year-old children born very preterm. Retinal OCT examinations might provide a deeper insight than mere eyesight in long-term neurodevelopmental follow-up of children born very preterm.
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Affiliation(s)
- Tuomo Lehtonen
- Department of Ophthalmology, University of Turku, Turku, Finland.,Turku University Hospital, Turku, Finland
| | - Eija Vesti
- Department of Ophthalmology, University of Turku, Turku, Finland.,Turku University Hospital, Turku, Finland
| | - Leena Haataja
- Department of Pediatric Neurology, University of Helsinki, and Pediatric Research Center, Helsinki University Hospital, Helsinki, Finland
| | - Anna Nyman
- Department of Psychology, University of Turku, Turku, Finland
| | - Karoliina Uusitalo
- Turku University Hospital, Turku, Finland.,Department of Pediatric Neurology, University of Turku, Turku, Finland
| | | | - Sirkku Setänen
- Turku University Hospital, Turku, Finland.,Department of Pediatric Neurology, University of Turku, Turku, Finland
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7
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Dyer KIC, Sanfilippo PG, Yazar S, Craig JE, Hewitt AW, Newnham JP, Mackey DA, Lee SSY. The Relationship Between Fetal Growth and Retinal Nerve Fiber Layer Thickness in a Cohort of Young Adults. Transl Vis Sci Technol 2022; 11:8. [PMID: 35819290 PMCID: PMC9287618 DOI: 10.1167/tvst.11.7.8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/05/2022] Open
Abstract
Purpose To explore relationships between patterns of fetal anthropometric growth, as reflective of fetal wellbeing, and global retinal nerve fiber layer (RNFL) thickness measured in young adulthood. Methods Participants (n = 481) from within a Western Australian pregnancy cohort study underwent five serial ultrasound scans during gestation, with fetal biometry measured at each scan. Optic disc parameters were measured via spectral-domain optical coherence tomography imaging at a 20-year follow-up eye examination. Generalized estimating equations were used to evaluate differences in global RNFL thickness between groups of participants who had undergone similar growth trajectories based on fetal head circumference (FHC), abdominal circumference (FAC), femur length (FFL), and estimated fetal weight (EFW). Results Participants with consistently large FHCs throughout gestation had significantly thicker global RNFLs than those with any other pattern of FHC growth (P = 0.023), even after adjustment for potential confounders (P = 0.037). Based on model fit statistics, FHC growth trajectory was a better predictor of global RNFL thickness than birth weight or head circumference at birth. RNFL thickness did not vary significantly between groups of participants with different growth trajectories based on FAC, FFL, or EFW. Conclusions FHC growth is associated with RNFL thickness in young adulthood and, moreover, is a better predictor than either birth weight or head circumference at birth. Translational Relevance This research demonstrates an association between intrauterine growth and long-term optic nerve health, providing a basis for further exploring the extent of the influence of fetal wellbeing on clinical conditions linked to RNFL thinning.
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Affiliation(s)
- Kathleen I C Dyer
- Centre for Ophthalmology and Visual Sciences (incorporating the Lions Eye Institute), University of Western Australia, Nedlands, Australia
| | - Paul G Sanfilippo
- Centre for Eye Research Australia, Royal Victorian Eye and Ear Hospital, University of Melbourne, Melbourne, Australia
| | - Seyhan Yazar
- Centre for Ophthalmology and Visual Sciences (incorporating the Lions Eye Institute), University of Western Australia, Nedlands, Australia.,Single Cell and Computational Genomics Laboratory, Garvan Institute of Medical Research, Darlinghurst, Australia
| | - Jamie E Craig
- Eye and Vision, Flinders Health and Medical Institute, Flinders University, Adelaide, Australia
| | - Alex W Hewitt
- Centre for Ophthalmology and Visual Sciences (incorporating the Lions Eye Institute), University of Western Australia, Nedlands, Australia.,Centre for Eye Research Australia, Royal Victorian Eye and Ear Hospital, University of Melbourne, Melbourne, Australia.,School of Medicine, Menzies Research Institute Tasmania, University of Tasmania, Hobart, Australia
| | - John P Newnham
- School of Women's and Infants' Health, The University of Western Australia, Perth, Australia
| | - David A Mackey
- Centre for Ophthalmology and Visual Sciences (incorporating the Lions Eye Institute), University of Western Australia, Nedlands, Australia.,Centre for Eye Research Australia, Royal Victorian Eye and Ear Hospital, University of Melbourne, Melbourne, Australia.,School of Medicine, Menzies Research Institute Tasmania, University of Tasmania, Hobart, Australia
| | - Samantha S Y Lee
- Centre for Ophthalmology and Visual Sciences (incorporating the Lions Eye Institute), University of Western Australia, Nedlands, Australia
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8
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Lucchesi M, Marracci S, Amato R, Filippi L, Cammalleri M, Dal Monte M. Neurosensory Alterations in Retinopathy of Prematurity: A Window to Neurological Impairments Associated to Preterm Birth. Biomedicines 2022; 10:biomedicines10071603. [PMID: 35884908 PMCID: PMC9313429 DOI: 10.3390/biomedicines10071603] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/22/2022] [Revised: 06/21/2022] [Accepted: 07/04/2022] [Indexed: 11/16/2022] Open
Abstract
Retinopathy of prematurity (ROP) is one of the main blinding diseases affecting preterm newborns and is classically considered a vascular disorder. The premature exposure to the extrauterine environment, which is hyperoxic in respect to the intrauterine environment, triggers a cascade of events leading to retinal ischemia which, in turn, makes the retina hypoxic thus setting off angiogenic processes. However, many children with a history of ROP show persistent vision impairment, and there is evidence of an association between ROP and neurosensory disabilities. This is not surprising given the strict relationship between neuronal function and an adequate blood supply. In the present work, we revised literature data evidencing to what extent ROP can be considered a neurodegenerative disease, also taking advantage from data obtained in preclinical models of ROP. The involvement of different retinal cell populations in triggering the neuronal damage in ROP was described along with the neurological outcomes associated to ROP. The situation of ROP in Italy was assessed as well.
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Affiliation(s)
- Martina Lucchesi
- Department of Biology, University of Pisa, 56127 Pisa, Italy; (M.L.); (S.M.); (R.A.); (M.C.)
| | - Silvia Marracci
- Department of Biology, University of Pisa, 56127 Pisa, Italy; (M.L.); (S.M.); (R.A.); (M.C.)
| | - Rosario Amato
- Department of Biology, University of Pisa, 56127 Pisa, Italy; (M.L.); (S.M.); (R.A.); (M.C.)
| | - Luca Filippi
- Department of Clinical and Experimental Medicine, Division of Neonatology and NICU, University of Pisa, 56126 Pisa, Italy;
| | - Maurizio Cammalleri
- Department of Biology, University of Pisa, 56127 Pisa, Italy; (M.L.); (S.M.); (R.A.); (M.C.)
| | - Massimo Dal Monte
- Department of Biology, University of Pisa, 56127 Pisa, Italy; (M.L.); (S.M.); (R.A.); (M.C.)
- Correspondence: ; Tel.: +39-050-2211426
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9
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Seely KR, Mangalesh S, Shen LL, McGeehan B, Ying GS, Sarin N, Vajzovic L, Prakalapakorn SG, Freedman SF, Toth CA. Association Between Retinal Microanatomy in Preterm Infants and 9-Month Visual Acuity. JAMA Ophthalmol 2022; 140:699-706. [PMID: 35653144 DOI: 10.1001/jamaophthalmol.2022.1643] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022]
Abstract
Importance Preterm infants are at risk for poor visual acuity (VA) outcomes, even without retinal problems on ophthalmoscopy. Infant retinal microanatomy may provide insight as to potential causes. Objective To evaluate the association between preterm infant retinal microanatomy and VA at 9 months' corrected age. Design, Setting, and Participants This prospective observational study took place from November 2016 and December 2019 at a single academic medical center and included preterm infants enrolled in Study of Eye Imaging in Preterm Infants (BabySTEPS). Infants were eligible for enrollment in BabySTEPS if they met criteria for retinopathy of prematurity (ROP) screening, were 35 weeks' postmenstrual age or older at the time of first OCT imaging, and a parent or guardian provided written informed consent. Of 118 infants enrolled in BabySTEPS, 61 were included in this analysis. Data were analyzed from March to April 2021. Exposures Bedside optical coherence tomography (OCT) imaging at a mean (SD) 39.85 (0.79) weeks' postmenstrual age and monocular grating VA measurement at 9 months' corrected age. Main Outcomes and Measures Presence and severity of macular edema and presence of ellipsoid zone at the fovea measured by extracting semiautomated thicknesses of inner nuclear layer, inner retina, and total retina at the foveal center; choroid across foveal 1 mm; and retinal nerve fiber layer (RNFL) across the papillomacular bundle (PMB). Pearson correlation coefficients were calculated and 95% CIs were bootstrapped for the association between retinal layer thicknesses and continuous logMAR VA. Associations were analyzed between retinal microanatomy and normal (3.70 cycles/degree or greater) vs subnormal grating VA at 9 months' corrected age using logistic regression and with logMAR VA using linear regression, adjusting for birth weight, gestational age, and ROP severity at the time of OCT imaging and accounting for intereye correlation using generalized estimating equations. Results The mean (SD; range) gestational age of included infants was 27.6 (2.8; 23.0-34.6) weeks, and mean (SD; range) birth weight was 958.2 (293.7; 480-1580) g. In 122 eyes of 61 infants, the correlations between retinal layer thicknesses and logMAR VA were as follows: r, 0.01 (95% CI, -0.07 to -0.27) for inner nuclear layer; r, 0.19 (95% CI, 0.01 to 0.35) for inner retina; r, 0.15 (95% CI, -0.02 to 0.31) for total retina; r, -0.22 (95% CI, -0.38 to -0.03) for choroid; and r, -0.27 (95% CI, -0.45 to 0.10) for RNFL across the PMB. In multivariable analysis, thinner RNFL across the PMB (regression coefficient, -0.05 per 10-μm increase in RNFL thickness; 95% CI, -0.10 to -0.01; P = .046) and prior ROP treatment (regression coefficient, 0.33 for ROP treatment; 95% CI, 0.11 to 0.56; P = .003) were independently associated with poorer 9-month logMAR VA. Conclusions and Relevance In preterm infants, RNFL thinning across the PMB was associated with poorer 9-month VA, independent of birth weight, gestational age, need for ROP treatment, and macular microanatomy. Evaluation of RNFL thickness using OCT may help identify preterm infants at risk for poor vision outcomes.
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Affiliation(s)
- Kai R Seely
- Department of Ophthalmology, Duke University School of Medicine, Durham, North Carolina
| | - Shwetha Mangalesh
- Department of Ophthalmology, Duke University School of Medicine, Durham, North Carolina
| | - Liangbo L Shen
- Department of Ophthalmology, Duke University School of Medicine, Durham, North Carolina.,Department of Ophthalmology, University of California, San Francisco
| | - Brendan McGeehan
- Center for Preventive Ophthalmology and Biostatistics, University of Pennsylvania, Philadelphia
| | - Gui-Shuang Ying
- Center for Preventive Ophthalmology and Biostatistics, University of Pennsylvania, Philadelphia
| | - Neeru Sarin
- Department of Ophthalmology, Duke University School of Medicine, Durham, North Carolina
| | - Lejla Vajzovic
- Department of Ophthalmology, Duke University School of Medicine, Durham, North Carolina
| | - S Grace Prakalapakorn
- Department of Ophthalmology, Duke University School of Medicine, Durham, North Carolina.,Department of Pediatrics, Duke University School of Medicine, Durham, North Carolina
| | - Sharon F Freedman
- Department of Ophthalmology, Duke University School of Medicine, Durham, North Carolina.,Department of Pediatrics, Duke University School of Medicine, Durham, North Carolina
| | - Cynthia A Toth
- Department of Ophthalmology, Duke University School of Medicine, Durham, North Carolina.,Department of Biomedical Engineering, Duke University, Durham, North Carolina
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Wu Q, Hu Y, Mo Z, Wu R, Zhang X, Yang Y, Liu B, Xiao Y, Zeng X, Lin Z, Fang Y, Wang Y, Lu X, Song Y, Ng WWY, Feng S, Yu H. Development and Validation of a Deep Learning Model to Predict the Occurrence and Severity of Retinopathy of Prematurity. JAMA Netw Open 2022; 5:e2217447. [PMID: 35708686 PMCID: PMC10881218 DOI: 10.1001/jamanetworkopen.2022.17447] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/09/2021] [Accepted: 04/29/2022] [Indexed: 01/18/2023] Open
Abstract
Importance Retinopathy of prematurity (ROP) is the leading cause of childhood blindness worldwide. Prediction of ROP before onset holds great promise for reducing the risk of blindness. Objective To develop and validate a deep learning (DL) system to predict the occurrence and severity of ROP before 45 weeks' postmenstrual age. Design, Setting, and Participants This retrospective prognostic study included 7033 retinal photographs of 725 infants in the training set and 763 retinal photographs of 90 infants in the external validation set, along with 46 characteristics for each infant. All images of both eyes from the same infant taken at the first screening were labeled according to the final diagnosis made between the first screening and 45 weeks' postmenstrual age. The DL system was developed using retinal photographs from the first ROP screening and clinical characteristics before or at the first screening in infants born between June 3, 2017, and August 28, 2019. Exposures Two models were specifically designed for predictions of the occurrence (occurrence network [OC-Net]) and severity (severity network [SE-Net]) of ROP. Five-fold cross-validation was applied for internal validation. Main Outcomes and Measures Area under the receiver operating characteristic curve (AUC), accuracy, sensitivity, and specificity to evaluate the performance in ROP prediction. Results This study included 815 infants (450 [55.2%] boys) with mean birth weight of 1.91 kg (95% CI, 1.87-1.95 kg) and mean gestational age of 33.1 weeks (95% CI, 32.9-33.3 weeks). In internal validation, mean AUC, accuracy, sensitivity, and specificity were 0.90 (95% CI, 0.88-0.92), 52.8% (95% CI, 49.2%-56.4%), 100% (95% CI, 97.4%-100%), and 37.8% (95% CI, 33.7%-42.1%), respectively, for OC-Net to predict ROP occurrence and 0.87 (95% CI, 0.82-0.91), 68.0% (95% CI, 61.2%-74.8%), 100% (95% CI, 93.2%-100%), and 46.6% (95% CI, 37.3%-56.0%), respectively, for SE-Net to predict severe ROP. In external validation, the AUC, accuracy, sensitivity, and specificity were 0.94, 33.3%, 100%, and 7.5%, respectively, for OC-Net, and 0.88, 56.0%, 100%, and 35.3%, respectively, for SE-Net. Conclusions and Relevance In this study, the DL system achieved promising accuracy in ROP prediction. This DL system is potentially useful in identifying infants with high risk of developing ROP.
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Affiliation(s)
- Qiaowei Wu
- Guangdong Eye Institute, Department of Ophthalmology, Guangdong Provincial People’s Hospital, Guangdong Academy of Medical Sciences, Guangzhou, China
- Department of Ophthalmology, General Hospital of Central Theater Command, Wuhan, China
| | - Yijun Hu
- Guangdong Eye Institute, Department of Ophthalmology, Guangdong Provincial People’s Hospital, Guangdong Academy of Medical Sciences, Guangzhou, China
| | - Zhenyao Mo
- Guangdong Provincial Key Laboratory of Computational Intelligence and Cyberspace Information, School of Computer Science and Engineering, South China University of Technology, Guangzhou, China
| | - Rong Wu
- Department of Ophthalmology, Zhujiang Hospital of Southern Medical University, Guangzhou, China
| | - Xiayin Zhang
- Guangdong Eye Institute, Department of Ophthalmology, Guangdong Provincial People’s Hospital, Guangdong Academy of Medical Sciences, Guangzhou, China
| | - Yahan Yang
- State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-sen University, Guangzhou, China
| | - Baoyi Liu
- State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-sen University, Guangzhou, China
| | - Yu Xiao
- Guangdong Eye Institute, Department of Ophthalmology, Guangdong Provincial People’s Hospital, Guangdong Academy of Medical Sciences, Guangzhou, China
| | - Xiaomin Zeng
- Guangdong Eye Institute, Department of Ophthalmology, Guangdong Provincial People’s Hospital, Guangdong Academy of Medical Sciences, Guangzhou, China
| | - Zhanjie Lin
- Guangdong Eye Institute, Department of Ophthalmology, Guangdong Provincial People’s Hospital, Guangdong Academy of Medical Sciences, Guangzhou, China
| | - Ying Fang
- Guangdong Eye Institute, Department of Ophthalmology, Guangdong Provincial People’s Hospital, Guangdong Academy of Medical Sciences, Guangzhou, China
| | - Yijin Wang
- Department of Neonatology, Second Nanning People’s Hospital, Nanning, China
| | - Xiaohe Lu
- Department of Ophthalmology, Zhujiang Hospital of Southern Medical University, Guangzhou, China
| | - Yanping Song
- Department of Ophthalmology, General Hospital of Central Theater Command, Wuhan, China
| | - Wing W. Y. Ng
- Guangdong Provincial Key Laboratory of Computational Intelligence and Cyberspace Information, School of Computer Science and Engineering, South China University of Technology, Guangzhou, China
| | - Songfu Feng
- Department of Ophthalmology, Zhujiang Hospital of Southern Medical University, Guangzhou, China
| | - Honghua Yu
- Guangdong Eye Institute, Department of Ophthalmology, Guangdong Provincial People’s Hospital, Guangdong Academy of Medical Sciences, Guangzhou, China
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11
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Papageorgiou E, Lazari K, Gottlob I. Hand-held optical coherence tomography: advancements in detection and assessment of optic nerve abnormalities and disease progression monitoring. EXPERT REVIEW OF OPHTHALMOLOGY 2022. [DOI: 10.1080/17469899.2022.2060821] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Affiliation(s)
- Eleni Papageorgiou
- Department of Ophthalmology, University Hospital of Larissa, Larissa, Greece
| | - Katerina Lazari
- Department of Ophthalmology, University Hospital of Larissa, Larissa, Greece
| | - Irene Gottlob
- Department of Neurology, Cooper Medical School of Rowan University and Cooper University Healthcare, Camden, New Jersey, USA
- Ulverscroft Eye Unit, Neuroscience, Psychology and Behaviour, Robert Kilpatrick Clinical Sciences Building, Leicester Royal Infirmary, University of Leicester, UK
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12
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Martínez-Córdoba CJ, Quijano-Nieto BA, Echeverría-González CL, Sierra-Bernal RM. A comparison of posterior segment optical coherence tomography findings in full-term and preterm children without retinopathy of prematurity. Indian J Ophthalmol 2021; 69:2151-2156. [PMID: 34304199 PMCID: PMC8482887 DOI: 10.4103/ijo.ijo_137_21] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
Purpose: Structural differences have been described in the retina of prematurely born children, including increased macular thickness caused by failed migration of the inner retina during development and retinal nerve fiber layer (RNFL) thinning related to low birth weight. The present study aimed to evaluate the differences in macular and RNFL optical coherence tomography (OCT) findings between full-term and preterm children without retinopathy of prematurity (ROP). Methods: Thirty-four premature (study group) and 43 full-term patients (control group)—aged 3 to 8 years—were studied. All children underwent a complete ophthalmological exam and OCT of the macula and optic nerve in both eyes to determine macular and RNFL thickness and morphology. Correlation analysis between central macular thickness, age, and visual acuity was also performed. Results: Central macular thickness was greater in the study group than in the control group; a difference of 14.2 μm was observed for the right eye (P = 0.002) and 12.16 μm for the left eye (P = 0.019). The thickness of the parafoveal and the perifoveal zones was consistently greater in the study group. 44.3% of eyes in the study group had mild forms of foveal hypoplasia (grades 1a and 1b) in qualitative description. No correlation between central macular thickness and visual acuity was found. There was no difference in RNFL thickness between both groups. Conclusion: Statistically significant structural differences were found in the macula of premature children, with a greater foveal thickness possibly reflecting retention of the inner retina during development, with no repercussion over visual acuity. RNFL thickness was similar in both groups.
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Affiliation(s)
- Claudia J Martínez-Córdoba
- Ophthalmology and Optometry Department - Hospital Militar Central; Medical and Surgical Specialties Unit - Universidad Militar Nueva Granada, Bogotá, Colombia
| | - Bernardo A Quijano-Nieto
- Ophthalmology and Optometry Department - Hospital Militar Central; Medical and Surgical Specialties Unit - Universidad Militar Nueva Granada; Macula and Retina Institute - Oftalmo Center, Bogotá, Colombia
| | - Claudia L Echeverría-González
- Medical and Surgical Specialties Unit - Universidad Militar Nueva Granada; Pediatrics and Neonatology Department - Hospital Militar Central, Bogotá, Colombia
| | - Rosa M Sierra-Bernal
- Ophthalmology and Optometry Department - Hospital Militar Central, Bogotá, Colombia
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13
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Shen LL, Mangalesh S, McGeehan B, Tai V, Sarin N, El-Dairi MA, Freedman SF, Maguire MG, Toth CA. Birth Weight Is a Significant Predictor of Retinal Nerve Fiber Layer Thickness at 36 Weeks Postmenstrual Age in Preterm Infants. Am J Ophthalmol 2021; 222:41-53. [PMID: 32891695 PMCID: PMC7930155 DOI: 10.1016/j.ajo.2020.08.043] [Citation(s) in RCA: 14] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/07/2020] [Revised: 08/25/2020] [Accepted: 08/28/2020] [Indexed: 12/16/2022]
Abstract
PURPOSE To assess retinal nerve fiber layer (RNFL) thickness in preterm infants. DESIGN Prospective observational study. METHODS We imaged 83 awake infants (159 eyes) at 36 ± 1 weeks postmenstrual age (defined as the time elapsed between the first day of the last maternal menstrual period and the time at imaging) using a handheld optical coherence tomography (OCT) system at the bedside. Blinded graders semi-automatically segmented RNFL in the papillomacular bundle (-15 to +15° relative to the fovea-optic nerve axis). We correlated RNFL thickness and 7 characteristics of interest (sex, race, ethnicity, gestational age, birth weight, stage of retinopathy at prematurity, and presence of pre-plus or plus disease) via univariable and multivariable regressions. RESULTS RNFL was 3.4 μm thicker in the right eyes than in the left eyes (P < .001). Among 7 characteristics, birth weight was the only independent predictor of RNFL thickness (P < .001). A 250-g increase in birth weight was associated with 5.2 μm (95% confidence interval: 3.3-7.0) increase in RNFL thickness. Compared with very preterm infants, extremely preterm infants had thinner RNFL (58.0 ± 10.7 μm vs 63.4 ± 10.7 μm, P = .03), but the statistical significance disappeared after adjustment for birth weight (P = .25). RNFL thickness was 11.2 μm thinner in extremely low birth weight infants than in very low birth weight infants (55.5 ± 8.3 μm vs. 66.7 ± 10.2 μm; P < .001). The difference remained statistically significant after adjustment for gestational age. CONCLUSION Birth weight is a significant independent predictor of RNFL thickness near birth, implying that the retinal ganglion cells reserve is affected by intrauterine processes that affect birth weight.
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Affiliation(s)
- Liangbo L Shen
- Department of Ophthalmology and Visual Science, Yale University School of Medicine, New Haven, Connecticut, USA
| | - Shwetha Mangalesh
- Department of Ophthalmology, Duke University School of Medicine, Durham, North Carolina, USA
| | - Brendan McGeehan
- Department of Ophthalmology, University of Pennsylvania, Philadelphia, Pennsylvania, USA
| | - Vincent Tai
- Department of Ophthalmology, Duke University School of Medicine, Durham, North Carolina, USA
| | - Neeru Sarin
- Department of Ophthalmology, Duke University School of Medicine, Durham, North Carolina, USA
| | - Mays A El-Dairi
- Department of Ophthalmology, Duke University School of Medicine, Durham, North Carolina, USA
| | - Sharon F Freedman
- Department of Ophthalmology, Duke University School of Medicine, Durham, North Carolina, USA
| | - Maureen G Maguire
- Department of Ophthalmology, University of Pennsylvania, Philadelphia, Pennsylvania, USA
| | - Cynthia A Toth
- Department of Ophthalmology, Duke University School of Medicine, Durham, North Carolina, USA; Department of Biomedical Engineering, Pratt School of Engineering, Duke University, Durham, North Carolina, USA.
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14
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Fieß A, Nickels S, Urschitz MS, Münzel T, Wild PS, Beutel ME, Lackner KJ, Hoffmann EM, Pfeiffer N, Schuster AK. Association of Birth Weight with Peripapillary Retinal Nerve Fiber Layer Thickness in Adulthood—Results from a Population-Based Study. ACTA ACUST UNITED AC 2020; 61:4. [PMID: 35917383 PMCID: PMC7425698 DOI: 10.1167/iovs.61.8.4] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
Abstract
Purpose Low birth weight is associated with altered retinal development in childhood, including reduced peripapillary retinal nerve fiber layer (pRNFL) thickness. However, to the best of our knowledge, no population-based study has analyzed the relationship of low birth weight to pRNFL thickness in adulthood. The purpose of this study was to investigate whether birth weight has a long-term effect on pRNFL thickness in adulthood. Methods In the German population-based Gutenberg Health Study (GHS), participants were examined with spectral-domain optical coherence tomography using a peripapillary scan and automated measurement of pRNFL thickness as a global parameter and in six sectors. The association between self-reported birth weight and the different pRNFL sectors were analyzed with multivariable linear regression, adjusted for potential confounders including sex, age, axial length, self-reported age-related macular degeneration, and glaucoma. Results In 3,028 participants, self-reported birth weight was documented and pRNFL measurements were successfully performed (1632 females, ages 54.9 ± 10.0 years). After adjustment for several confounders in the multivariable model, a positive association was observed between birth weight and pRNFL thickness in the global sector (β = 0.13 µm/100 g; 95% CI, 0.08–0.18; P < 0.001; R2 = 0.007) and especially in the inferotemporal sector (β = 0.22 µm/100 g; 95% CI, 0.15–0.29; P < 0.001; R2 = 0.008) and inferonasal sector (β = 0.28 µm/100 g; 95% CI, 0.17–0.39; P < 0.001; R2 = 0.005). Conclusions Our data show that there is a weak relationship between birth weight and pRNFL thickness in adulthood. This weak association is particularly present in the inferior part of the optic nerve head. Therefore, low birth weight may have an impact on optic nerve head development and potentially on ocular disease development.
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Affiliation(s)
- Achim Fieß
- Department of Ophthalmology, University Medical Center, Johannes Gutenberg University Mainz, Mainz, Germany
| | - Stefan Nickels
- Department of Ophthalmology, University Medical Center, Johannes Gutenberg University Mainz, Mainz, Germany
| | - Michael S. Urschitz
- Division of Pediatric Epidemiology, Institute for Medical Biostatistics, Epidemiology and Informatics, University Medical Center, Johannes Gutenberg University Mainz, Mainz, Germany
| | - Thomas Münzel
- Center for Cardiology–Cardiology I, University Medical Center, Johannes Gutenberg University Mainz, Mainz, Germany
| | - Philipp S. Wild
- Preventive Cardiology and Preventive Medicine/Center for Cardiology, University Medical Center, Johannes Gutenberg University Mainz, Mainz, Germany
- Center for Thrombosis and Hemostasis, University Medical Center, Johannes Gutenberg University Mainz, Mainz, Germany
- German Center for Cardiovascular Research (DZHK), partner site Rhine-Main, Mainz, Germany
| | - Manfred E. Beutel
- Department of Psychosomatic Medicine and Psychotherapy, University Medical Center, Johannes Gutenberg University Mainz, Mainz, Germany
| | - Karl J. Lackner
- Institute of Clinical Chemistry and Laboratory Medicine, University Medical Center, Johannes Gutenberg University Mainz, Mainz, Germany
| | - Esther M. Hoffmann
- Department of Ophthalmology, University Medical Center, Johannes Gutenberg University Mainz, Mainz, Germany
| | - Norbert Pfeiffer
- Department of Ophthalmology, University Medical Center, Johannes Gutenberg University Mainz, Mainz, Germany
| | - Alexander K. Schuster
- Department of Ophthalmology, University Medical Center, Johannes Gutenberg University Mainz, Mainz, Germany
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Lee GI, Park KA, Oh SY, Kong DS. Analysis of Optic Chiasmal Compression Caused by Brain Tumors Using Optical Coherence Tomography Angiography. Sci Rep 2020; 10:2088. [PMID: 32034270 PMCID: PMC7005681 DOI: 10.1038/s41598-020-59158-1] [Citation(s) in RCA: 14] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/26/2019] [Accepted: 12/10/2019] [Indexed: 11/10/2022] Open
Abstract
We have quantitatively evaluated the macular and peripapillary microvascular changes in eyes with chiasmal compression caused by brain tumors compared with healthy control eyes using optical coherence tomography angiography (OCT-A) and correlated them with other ocular parameters. This cross-sectional study involved the analysis of 36 eyes of 36 patients with chiasmal compression and age and refractive error-matched 35 healthy control eyes. OCT-A was used to generate microvascular images of the superficial and deep retinal capillary plexus (SRCP, DRCP) and the radial peripapillary capillary (RPC) segment in the macula and peripapillary areas. Automated segmentation and vessel density measurements facilitated the analysis of each layer. Macular OCT-A analysis revealed a significant reduction in vessel density in the SRCP (P = 0.004) of the nasal quadrant (P < 0.001) and in the same quadrant of the DRCP (P = 0.019) in the eyes with chiasmal compression compared with the control eyes. The RPC segment vessel density has also been significantly reduced in the eyes with chiasmal compression (P < 0.001). The RPC segment and the SRCP vessel densities were correlated with the peripapillary retinal nerve fiber layer and the ganglion cell layer complex thicknesses. The RPC segment and the nasal quadrant SRCP and the DRCP vessel densities were correlated with visual field defect. Significant microvascular alterations have been detected in the eyes with chiasmal compression compared with the control eyes. This study confirmed that chiasmal compression caused by brain tumors not only induced a loss of ganglion cells but also resulted in intra-retinal microvascular changes.
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Affiliation(s)
- Ga-In Lee
- Department of Ophthalmology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - Kyung-Ah Park
- Department of Ophthalmology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - Sei Yeul Oh
- Department of Ophthalmology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea.
| | - Doo-Sik Kong
- Department of Neurosurgery, Endoscopic Skull Base Surgery Clinic, Brain Tumor Center, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea.
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16
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Morken TS, Dammann O, Skranes J, Austeng D. Retinopathy of prematurity, visual and neurodevelopmental outcome, and imaging of the central nervous system. Semin Perinatol 2019; 43:381-389. [PMID: 31174874 DOI: 10.1053/j.semperi.2019.05.012] [Citation(s) in RCA: 23] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/15/2023]
Abstract
Recent findings indicate that retinopathy of prematurity (ROP), presently classified by clinical examinations of retinal vascular tissue, is associated with structural alterations of the central nervous system. Such alterations may be the correlate of the association between ROP and impaired long-term neurocognitive and visual development. The advent of imaging techniques such as structural and diffusion tensor magnetic resonance imaging of the brain, and optical coherence tomography of the retina, will allow the complete visual system to be characterized in greater detail. It has been suggested that ROP may be not only a vascular, but a neurovascular disease, being part of a spectrum that includes pathological development in both the retinal and cerebral neurovascular interphase. We review the present knowledge in the field and point to future directions for research to tackle these questions.
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Affiliation(s)
- Tora Sund Morken
- Department of Neuromedicine and Movement Science, Norwegian University of Science and Technology (NTNU), Trondheim, Norway; Norway and Department of Ophthalmology, St. Olavs Hospital, Trondheim University Hospital, Trondheim, Norway.
| | - Olaf Dammann
- Department of Neuromedicine and Movement Science, Norwegian University of Science and Technology (NTNU), Trondheim, Norway; Department of Public Health and Community Medicine, Tufts University School of Medicine, Boston, MA, USA; Department of Gynecology and Obstetrics, Hannover Medical School, Hannover, Germany
| | - Jon Skranes
- Department of Clinical and Molecular Medicine, NTNU, Trondheim, Norway; Department of Child Neurology and Rehabilitation and Regional Competence Center for children with prenatal alcohol/drug exposure, Sørlandet Hospital, Arendal, Norway
| | - Dordi Austeng
- Department of Neuromedicine and Movement Science, Norwegian University of Science and Technology (NTNU), Trondheim, Norway; Norway and Department of Ophthalmology, St. Olavs Hospital, Trondheim University Hospital, Trondheim, Norway
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17
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Rosén RM, Hellgren KM, Venkataraman AP, Dominguez Vicent A, Nilsson M. INCREASED FOVEAL GANGLION CELL AND INNER PLEXIFORM LAYER THICKNESS IN CHILDREN AGED 6.5 YEARS BORN EXTREMELY PRETERM. Retina 2019; 40:1344-1352. [PMID: 31157715 DOI: 10.1097/iae.0000000000002581] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
PURPOSE To analyze the ganglion cell layer and inner plexiform layer (GCL+) thickness in children born extremely preterm and control children. METHODS A study of 6.5-year-old children born before the gestational age of 27 weeks and age-matched controls. The GCL+ thickness and foveal depth (FD) were analyzed in a single optical coherence tomography B-scan. Association with neonatal risk factors and sex was investigated. Extremely preterm was divided into no, mild, and severe retinopathy of prematurity, retinopathy of prematurity treatment, and no, mild, and severe intraventricular hemorrhage. RESULTS Adequate measurements were obtained from 89 children born extremely preterm and 92 controls. Extremely preterm children had increased total (5 µm, P < 0.001) and central (21 µm, P < 0.001) GCL+ thickness and reduced FD (-53 µm, P < 0.001) compared with controls. Extremely preterm children receiving retinopathy of prematurity treatment had increased GCL+ thickness and reduced FD compared with other subgroups. Sex and gestational age were associated with increased central GCL+ thickness and reduced FD. Reduced total GCL+ thickness was associated with severe intraventricular hemorrhage. CONCLUSION Extremely preterm birth can cause incomplete extrusion of the GCL+ and reduced FD. Retinopathy of prematurity treatment, gestational age, and male sex were associated to increased central GCL+ thickness and reduced FD, while severe intraventricular hemorrhage was associated with reduced total GCL+ thickness.
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Affiliation(s)
- Rebecka M Rosén
- Department of Clinical Neuroscience, Karolinska Institutet, Stockholm, Sweden; and
| | - Kerstin M Hellgren
- Department of Clinical Neuroscience, Karolinska Institutet, Stockholm, Sweden; and.,Astrid Lindgren Children's Hospital, Karolinska University Hospital, Stockholm, Sweden
| | | | | | - Maria Nilsson
- Department of Clinical Neuroscience, Karolinska Institutet, Stockholm, Sweden; and
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18
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Fieß A, Kölb-Keerl R, Schuster AK, Knuf M, Kirchhof B, Muether PS, Bauer J. Correlation of morphological parameters and visual acuity with neurological development in former preterm children aged 4-10 years. Acta Ophthalmol 2018. [PMID: 29524311 DOI: 10.1111/aos.13755] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/04/2023]
Abstract
PURPOSE The objective of this study was to investigate the relationship between visual acuity, peripapillary retinal nerve fibre layer (pRNFL), retinal thickness at the fovea and other factors with the neurologic status of former preterm children. METHODS In this cross-sectional hospital based study in a maximum care tertiary centre, detailed anthropometric and ophthalmological data of former preterm children ranging from 4 to 10 years of age with a gestational age (GA) ≤32 weeks were assessed. Analyses of the correlation between pRNFL and foveal thickness, as well as visual acuity (VA) parameters at 4-10 years of age, with neurological development were evaluated at 2 years of age by Bayley Scales II of Infant Development, including Psychomotor Developmental Index (PDI) and Mental Developmental Index (MDI). RESULTS Data were available for 106 former preterm children. Univariate analysis revealed a correlation between PDI with pRNFL thickness (B = 0.43; p = 0.013), VA (B = -29.2; p < 0.001), GA (B = 2.7; p = 0.002), retinopathy of prematurity (ROP; B = -16.3; p < 0.001) and intraventricular haemorrhages (IVH; B = -22.9; p < 0.001) but not with strabismus or foveal thickness. In the multivariable analysis, the association remained for visual acuity and IVH, but not for pRNFL thickness or ROP. Mental Developmental Index (MDI) was associated with visual acuity (B = -34.3; p = 0.001), GA (B = 2.53; p = 0.02) and IVH (B = -15.4; p = 0.02), the latter also in the multivariable analysis. CONCLUSION This study revealed an association between PDI at 2 years of age and lower visual acuity later in childhood. However, there was no correlation between retinal morphology and neurologic outcome in former preterm children after adjusting for several potential confounders.
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Affiliation(s)
- Achim Fieß
- Department of Ophthalmology; Helios Dr. Horst Schmidt Klinik; Wiesbaden Germany
- Department of Ophthalmology; University Medical Centre Mainz; Mainz Germany
| | - Ruth Kölb-Keerl
- Department of Ophthalmology; Helios Dr. Horst Schmidt Klinik; Wiesbaden Germany
| | | | - Markus Knuf
- Department of Paediatrics; Helios Dr. Horst Schmidt Klinik; Wiesbaden Germany
| | - Bernd Kirchhof
- Department of Ophthalmology; University of Cologne; Cologne Germany
| | | | - Jacqueline Bauer
- Department of Paediatrics; Helios Dr. Horst Schmidt Klinik; Wiesbaden Germany
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19
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Lee YS, See LC, Chang SH, Wang NK, Hwang YS, Lai CC, Chen KJ, Wu WC. Macular Structures, Optical Components, and Visual Acuity in Preschool Children after Intravitreal Bevacizumab or Laser Treatment. Am J Ophthalmol 2018; 192:20-30. [PMID: 29753851 DOI: 10.1016/j.ajo.2018.05.002] [Citation(s) in RCA: 28] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/13/2018] [Revised: 04/28/2018] [Accepted: 05/03/2018] [Indexed: 01/19/2023]
Abstract
PURPOSE To investigate the macular structures, optical components, and visual acuity in preschool-aged children with a history of type I retinopathy of prematurity who underwent either intravitreal bevacizumab (IVB), laser, or a combination of treatments. DESIGN Comparative interventional case series. METHODS Setting: A referred medical center in Taiwan. STUDY POPULATION Eighty eyes from 42 patients (33 IVB-treated eyes from 17 children, 24 laser-treated eyes from 13 children, and 23 laser + IVB-treated eyes from 12 children). OBSERVATION PROCEDURE Spectral-domain optical coherence tomography. MAIN OUTCOME MEASURES The retinal thickness in the foveal area and the associated morphologic changes in foveal depression. RESULTS Compared with the laser-treated and laser + IVB-treated eyes, the IVB-treated eyes had less myopia and deeper anterior chamber depths but presented similar axial lengths and corneal curvatures (P = .001, P = .002, P = .95, and P = .16, respectively). The IVB-treated eyes had significantly thinner foveal, parafoveal, and perifoveal retinal thicknesses (P < .01 for all) and a higher incidence of foveal depression than the laser- or laser + IVB-treated eyes. The macular and subfoveal choroidal thicknesses did not differ among the groups (P = .21 and P = .63, respectively). Moreover, compared with the eyes treated with laser or laser + IVB, the IVB-treated eyes had better uncorrected visual acuity, although a significant difference was not observed in best-corrected visual acuity (P = .008 and P = .29, respectively). CONCLUSIONS Compared with laser therapy, IVB-treated eyes were associated with deeper anterior chamber depths and thinner foveal, parafoveal, and perifoveal thicknesses. Moreover, these IVB-treated eyes had fewer refractive errors and better uncorrected visual acuity.
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Affiliation(s)
- Yung-Sung Lee
- Department of Ophthalmology, Chang Gung Memorial Hospital, Taoyuan, Taiwan
| | - Lai-Chu See
- Division of Rheumatology, Allergy and Immunology, Department of Internal Medicine, Chang Gung Memorial Hospital, Taoyuan, Taiwan; Department of Public Health, College of Medicine, Chang Gung University, Taoyuan, Taiwan; Biostatistics Core Laboratory, Molecular Medicine Research Centre, Chang Gung University, Taoyuan, Taiwan
| | - Shu-Hao Chang
- Department of Public Health, College of Medicine, Chang Gung University, Taoyuan, Taiwan
| | - Nan-Kai Wang
- Department of Ophthalmology, Chang Gung Memorial Hospital, Taoyuan, Taiwan; College of Medicine, Chang Gung University, Taoyuan, Taiwan
| | - Yih-Shiou Hwang
- Department of Ophthalmology, Chang Gung Memorial Hospital, Taoyuan, Taiwan; College of Medicine, Chang Gung University, Taoyuan, Taiwan
| | - Chi-Chun Lai
- Department of Ophthalmology, Chang Gung Memorial Hospital, Taoyuan, Taiwan; College of Medicine, Chang Gung University, Taoyuan, Taiwan
| | - Kuan-Jen Chen
- Department of Ophthalmology, Chang Gung Memorial Hospital, Taoyuan, Taiwan; College of Medicine, Chang Gung University, Taoyuan, Taiwan
| | - Wei-Chi Wu
- Department of Ophthalmology, Chang Gung Memorial Hospital, Taoyuan, Taiwan; College of Medicine, Chang Gung University, Taoyuan, Taiwan.
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20
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Glass TJA, Chau V, Gardiner J, Foong J, Vinall J, Zwicker JG, Grunau RE, Synnes A, Poskitt KJ, Miller SP. Severe retinopathy of prematurity predicts delayed white matter maturation and poorer neurodevelopment. Arch Dis Child Fetal Neonatal Ed 2017; 102:F532-F537. [PMID: 28536205 DOI: 10.1136/archdischild-2016-312533] [Citation(s) in RCA: 58] [Impact Index Per Article: 8.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/15/2016] [Revised: 04/04/2017] [Accepted: 04/06/2017] [Indexed: 11/04/2022]
Abstract
OBJECTIVE To determine whether severe retinopathy of prematurity (ROP) is associated with (1) abnormal white matter maturation and (2) neurodevelopmental outcomes at 18 months' corrected age (CA) compared with neonates without severe ROP. DESIGN We conducted a prospective longitudinal cohort of extremely preterm neonates born 24-28 weeks' gestational age recruited between 2006 and 2013 with brain MRIs obtained both early in life and at term-equivalent age. Severe ROP was defined as ROP treated with retinal laser photocoagulation. Using diffusion tensor imaging and tract-based spatial statistics (TBSS), white matter maturation was assessed by mean fractional anisotropy (FA) in seven predefined regions of interest. Neurodevelopmental outcomes were assessed with Bayley Scales of Infant and Toddler Development-III (Bayley-III) composite scores at 18 months' CA. Subjects were compared using Fisher's exact, Kruskal-Wallis and generalised estimating equations. SETTING Families were recruited from the neonatal intensive care unit at BC Women's Hospital. PATIENTS Of 98 extremely preterm neonates (median: 26.0 weeks) assessed locally for ROP, 19 (19%) had severe ROP and 83 (85%) were assessed at 18 months' CA. RESULTS Severe ROP was associated with lower FA in the posterior white matter, and with decreased measures of brain maturation in the optic radiations, posterior limb of the internal capsule (PLIC) and external capsule on TBSS. Bayley-III cognitive and motor scores were lower in infants with severe ROP. CONCLUSIONS Severe ROP is associated with maturational delay in the optic radiations, PLIC, external capsule and posterior white matter, housing the primary visual and motor pathways, and is associated with poorer cognitive and motor outcomes at 18 months' CA.
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Affiliation(s)
- Torin J A Glass
- Department of Pediatrics (Neurology), University of Toronto and the Hospital for Sick Children, Toronto, Canada.,Neurosciences & Mental Health, SickKids Research Institute, Toronto, Canada
| | - Vann Chau
- Department of Pediatrics (Neurology), University of Toronto and the Hospital for Sick Children, Toronto, Canada.,Neurosciences & Mental Health, SickKids Research Institute, Toronto, Canada.,BC Children's Hospital Research Institute, Vancouver, Canada
| | - Jane Gardiner
- BC Children's Hospital Research Institute, Vancouver, Canada.,Department of Ophthalmology and Vision Science, University of British Columbia and BC Children's Hospital, Vancouver, Canada
| | - Justin Foong
- Neurosciences & Mental Health, SickKids Research Institute, Toronto, Canada
| | - Jillian Vinall
- Department of Anesthesiology, University of Calgary, Calgary, Canada
| | - Jill G Zwicker
- BC Children's Hospital Research Institute, Vancouver, Canada.,Department of Pediatrics (Developmental Pediatrics), University of British Columbia and BC Children's and Women's Hospitals, Vancouver, Canada.,Department of Occupational Science and Occupational Therapy, Vancouver, Canada.,Sunny Hill Health Centre for Children, Vancouver, Canada
| | - Ruth E Grunau
- BC Children's Hospital Research Institute, Vancouver, Canada.,Department of Pediatrics (Neonatology), University of British Columbia and BC Children's and Women's Hospitals, Vancouver, Canada
| | - Anne Synnes
- BC Children's Hospital Research Institute, Vancouver, Canada.,Department of Pediatrics (Neonatology), University of British Columbia and BC Children's and Women's Hospitals, Vancouver, Canada
| | - Kenneth J Poskitt
- BC Children's Hospital Research Institute, Vancouver, Canada.,Department of Radiology, University of British Columbia and BC Children's Hospital, Vancouver, Canada
| | - Steven P Miller
- Department of Pediatrics (Neurology), University of Toronto and the Hospital for Sick Children, Toronto, Canada.,Neurosciences & Mental Health, SickKids Research Institute, Toronto, Canada.,BC Children's Hospital Research Institute, Vancouver, Canada
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21
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The inner retinal structures of the eyes of children with a history of retinopathy of prematurity. Eye (Lond) 2017; 32:104-112. [PMID: 28776594 DOI: 10.1038/eye.2017.156] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/12/2017] [Accepted: 06/21/2017] [Indexed: 11/08/2022] Open
Abstract
PurposeTo investigate the microstructural differences of the inner retina in the peripapillary and macular areas in children with or without retinopathy of prematurity (ROP).MethodsThis prospective cohort study included school-age children with a history of ROP and age-matched healthy, full-term children. The macular ganglion cell complex (mGCC), peripapillary retinal nerve fiber layer (RNFL), refractive status, and ocular biometry were measured. The metrics of the mGCC and associated anatomical changes were the primary outcomes. Mann-Whitney U tests and chi-squared tests were used to compare variables between the two groups.ResultsA total of 41 eyes from 21 preterm children with ROP and 34 eyes from 17 full-term children were enrolled. ROP eyes had significantly thicker mGCC (P<0.001) with uneven distribution compared with full-term eyes. The RNFLs of ROP eyes were thicker in the temporal quadrants but thinner in the nasal quadrants (P=0.01 and.04, respectively). In addition, the ROP eyes had shallower anterior chamber depths (ACDs), thicker lenses, and higher degrees of refractive errors (all P<0.05) but similar axial lengths (ALs) (P=0.58) compared with full-term eyes.ConclusionsThe mGCC was thicker in children with ROP, and their inner retinal structures had a different distribution pattern than those in full-term children. The myopia of children with ROP was associated with the abnormal development of the anterior segment rather than long ALs. These alterations in inner retinal anatomy and optic components emphasize the importance of careful examinations to monitor the development of glaucoma or visual decline in children with ROP.
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22
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Raffa LH, Nilsson J, Dahlgren J, Grönlund MA. Electrophysiological changes in 12-year-old children born MLP: reduced VEP amplitude in MLP children. Br J Ophthalmol 2017; 101:1156-1161. [DOI: 10.1136/bjophthalmol-2016-309536] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/24/2016] [Revised: 11/21/2016] [Accepted: 12/20/2016] [Indexed: 11/04/2022]
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23
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Creavin AL, Williams CEM, Tilling K, Luyt K, Timpson N, Higgins JPT. The range of peripapillary retinal nerve fibre layer and optic disc parameters, in children aged up to but not including 18 years of age who were born prematurely: protocol for a systematic review. Syst Rev 2016; 5:144. [PMID: 27577553 PMCID: PMC5006449 DOI: 10.1186/s13643-016-0319-0] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/18/2016] [Accepted: 08/16/2016] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND The parameters of the optic disc and peripapillary retinal nerve fibre layer (pRNFL) in premature children may vary with disease processes that contribute to visual impairment and blindness and so could be useful as an objective measure in at-risk children. METHODS A systematic review of current literature on the range of pRNFL and optic disc parameters in children aged less than 18 years, who were born before 37 weeks gestation, will be performed. The bibliographic databases MEDLINE, CINAHL, EMBASE, Scopus and Web of Science will be systematically searched. Where possible and appropriate, study-specific estimates will be combined using meta-analysis to obtain an overall summary estimate of pRNFL thickness and cup-disc ratio across studies, and results will be presented by age of population. DISCUSSION This review aims to improve understanding of what might be considered within/outside the range of normality for this high-risk group. SYSTEMATIC REVIEW REGISTRATION The review is registered on PROSPERO CRD42016037933.
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Affiliation(s)
- Alexandra L. Creavin
- MRC Integrative Epidemiology Unit, School of Social and Community Medicine, University of Bristol, Oakfield House, Oakfield Grove Clifton, Bristol, BS8 2BN UK
- Centre for Child and Adolescent Health, School of Social and Community Medicine, University of Bristol, Bristol, UK
| | - Cathy E. M. Williams
- Centre for Child and Adolescent Health, School of Social and Community Medicine, University of Bristol, Bristol, UK
| | - Kate Tilling
- MRC Integrative Epidemiology Unit, School of Social and Community Medicine, University of Bristol, Oakfield House, Oakfield Grove Clifton, Bristol, BS8 2BN UK
| | - Karen Luyt
- School of Clinical Sciences, University of Bristol, Bristol, UK
| | - Nicholas Timpson
- MRC Integrative Epidemiology Unit, School of Social and Community Medicine, University of Bristol, Oakfield House, Oakfield Grove Clifton, Bristol, BS8 2BN UK
| | - Julian P. T. Higgins
- MRC Integrative Epidemiology Unit, School of Social and Community Medicine, University of Bristol, Oakfield House, Oakfield Grove Clifton, Bristol, BS8 2BN UK
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24
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Rothman AL, Mangalesh S, Chen X, Toth CA. Optical coherence tomography of the preterm eye: from retinopathy of prematurity to brain development. Eye Brain 2016; 8:123-133. [PMID: 28539807 PMCID: PMC5398750 DOI: 10.2147/eb.s97660] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/28/2022] Open
Abstract
Preterm infants with retinopathy of prematurity are at increased risk of poor neurodevelopmental outcomes. Because the neurosensory retina is an extension of the central nervous system, anatomic abnormalities in the anterior visual pathway often relate to system and central nervous system health. We describe optical coherence tomography as a powerful imaging modality that has recently been adapted to the infant population and provides noninvasive, high-resolution, cross-sectional imaging of the infant eye at the bedside. Optical coherence tomography has increased understanding of normal eye development and has identified several potential biomarkers of brain abnormalities and poorer neurodevelopment.
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Affiliation(s)
- Adam L Rothman
- Department of Ophthalmology, Duke University School of Medicine, Durham.,Department of Internal Medicine, Cone Health, Greensboro
| | - Shwetha Mangalesh
- Department of Ophthalmology, Duke University School of Medicine, Durham
| | - Xi Chen
- Department of Ophthalmology, Duke University School of Medicine, Durham
| | - Cynthia A Toth
- Department of Ophthalmology, Duke University School of Medicine, Durham.,Department of Biomedical Engineering, Pratt School of Engineering, Duke University, Durham, NC, USA
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