A Neuroectodermal Hypothesis of the Cause and Relationship of Myopia in Retinopathy of Prematurity

Beri, Sarita; Malhotra, Mridula; Dhawan, Anuradha; Garg, Rajiv; Jain, Rajesh; D'souza, Pamela

doi:10.3928/01913913-20090505-05

Cited by 7 publications

(5 citation statements)

References 18 publications

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“…It is suspected that these eyes have a relatively short ACD at birth, which may be due to altered neuroectodermal development or inadequate biological stress, leading to retardation of ocular growth. 12,13 This theory may be supported by longitudinal studies on premature children, which revealed that premature infants with small eyes have a shallower anterior chamber, thicker lens and flatter cornea than full-term infants. 14 As expected, this study observed a difference in the ocular parameters with respect to sex.…”

Section: Discussionmentioning

confidence: 95%

“…Compared to those with low hyperopia, moderate to high hyperopic eyes have a flatter corneal curvature and a shorter ACD but thicker LT. It is suspected that these eyes have a relatively short ACD at birth, which may be due to altered neuroectodermal development or inadequate biological stress, leading to retardation of ocular growth 12,13 . This theory may be supported by longitudinal studies on premature children, which revealed that premature infants with small eyes have a shallower anterior chamber, thicker lens and flatter cornea than full‐term infants 14 .…”

Section: Discussionmentioning

confidence: 99%

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Lens power, cornea power and association with refractive error in children with moderate to high hyperopia

Wang,

Luo,

Zhuo

et al. 2024

Ophthalmic Physiologic Optic

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ObjectiveThis study aimed to profile ocular biometry parameters and predictors of spherical equivalent refraction (SER) among children with moderate to high hyperopia.MethodsIndividuals <18 years of age with moderate to high hyperopia were enrolled from November 2015 to November 2021. Participants underwent a series of comprehensive ocular examinations, and were classified as having low hyperopia, that is, SER +0.5 to < +2.0 D or moderate to high hyperopia, that is, SER ≥ +2.0 D.ResultsA total of 459 and 230 eyes with moderate to high hyperopia and low hyperopia, respectively, were included. Moderate to high hyperopic eyes had a shorter axial length, stronger lens power (24.78 ± 5.47 D vs. 18.74 ± 1.63 D, p < 0.001) and weaker corneal power (42.82 ± 1.75 D vs. 43.31 ± 1.55 D, p < 0.001) than low hyperopic eyes. When comparing values before and after 5 years of age, both lens power and axial length differed significantly in the moderate to high hyperopia group, whereas in the low hyperopia group, they only differed significantly after 9 years of age. Lens power was negatively associated with AL in eyes with axial lengths between 20 and 22 mm. A multiple linear regression model which included axial length (standardised β = −0.80, p < 0.001), corneal power (standardised β = −0.47, p < 0.001) and lens power (standardised β = 0.23, p < 0.001) explained 81.2% of the variance in SER.ConclusionsDifferences in lens power and axial length in moderate to high hyperopic eyes became significantly smaller after 5 years of age, at least 4 years earlier than for the low hyperopia. Lens power could offset the axial elongation in participants with axial lengths between 20 and 22 mm, suggesting that children with moderate to high hyperopia might have different ocular growth patterns. Axial length, corneal power and lens power were the main predictors of SER in moderate to high hyperopia.

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Section: Discussionmentioning

confidence: 95%

Section: Discussionmentioning

confidence: 99%

Lens power, cornea power and association with refractive error in children with moderate to high hyperopia

Wang,

Luo,

Zhuo

et al. 2024

Ophthalmic Physiologic Optic

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“…The changes of biometric features in ROP-affected eyes are currently thought to arise mainly from the mechanical restriction on anterior sclera and preoptic segment secondary to its peripheral avascular zone 34 and altered neuroectodermal development. 35 This concept may provide the grounds to explore the cause for the unique eye morphology of FEVR patients who share similar clinical features, especially the peripheral retinal avascular zones.…”

Section: Discussionmentioning

confidence: 99%

Refractive Status and Biometric Characteristics of Children With Familial Exudative Vitreoretinopathy

Hu,

Fan,

Zhao

et al. 2023

Invest. Ophthalmol. Vis. Sci.

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Purpose To compare biometric characteristics between patients with early-stage familial exudative vitreoretinopathy (FEVR) and healthy controls. Methods This case-control study included 50 FEVR eyes in stage 1-2 and 50 control eyes matched by age, gender and spherical equivalent (SE). Biometric parameters including axial length (AL), white-to-white diameter (WTW), central corneal thickness (CCT), anterior chamber depth (ACD), lens thickness (LT), pupil diameter, vitreous chamber depth, anterior and posterior corneal surface curvature radius (ACR and PCR), anterior lens surface curvature radius (ALR) and posterior lens surface curvature radius were measured using IOLMaster 700 and compared between cases and controls using paired t -test. Correlations between SE and biometric measures were assessed using Pearson correlation coefficient ( r ) in cases and controls. Results Both FEVR cases and matched controls had a mean age of 7.6 years, 48% female and mean SE of −5.3 D (80% myopia). Compared to controls, FEVR eyes had smaller AL ( P = 0.009), WTW ( P = 0.001), ACD ( P < 0.001), and ALR ( P = 0.03), but larger CCT ( P = 0.02) and LT ( P = 0.01). In FEVR eyes, SE was negatively correlated with AL ( r = −0.79, P < 0.001), positively correlated with ACR ( r = 0.29, P = 0.04) and PCR ( r = 0.33, P = 0.02), whereas in controls, SE was negatively correlated with AL ( r = −0.82, P < 0.001) and LT ( r = −0.34, P = 0.02), positively correlated with ALR ( r = 0.29, P = 0.04). Conclusions Patients at early stage of FEVR exhibited a unique eye morphology resembling ocular development arrest, which may help to develop screening and early detection tools for FEVR. In FEVR patients, myopia is very prevalent and significantly associated with corneal curvature increase.

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“…Another theory was the neuroectodermal hypothesis, which refers to the absence of an anterior segment block leading to an increase in LT due to altered neuroectodermal development in patients with ROP. It has been suggested that ROP lesions are located at the site of the eye with the fastest growth, which in turn limits the growth of the anterior sclera and the preoptic segment ( 34 ). Additionally, there was a theory that inadequate temperature or biological stress during corneal growth and development could also lead to developmental blockage of the anterior segment.…”

Section: Discussionmentioning

confidence: 99%

Refractive status and optical components in premature infants with and without retinopathy of prematurity: A 4- to 5-year cohort study

et al. 2022

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This study was aimed to investigate the characteristics of refractive parameters in premature infants and children aged 3–8 years with mild retinopathy of prematurity (ROP) and to explore the effects of premature delivery and mild ROP on the development of refractive status and ocular optical components. Premature infants who underwent ocular fundus oculi screening in our hospital between January 2009 and February 2011 were included and divided into the ROP group and the non-ROP group. Full-term infants were the controls. The results of the annual ocular examination conducted between 2014 and 2018 were analysed, and the refractive status, optical components, and developmental trends were compared among the three groups. The total follow-up time was 4–5 years. The prevalence of myopia and astigmatism was high in the ROP group (P < 0.05). In the non-ROP group, the prevalence of myopia was also higher than that in the control group. The prevalence of myopia increased with age in the ROP and non-ROP groups, while the prevalence of astigmatism remained unchanged. In the ROP group, the corneal refractive power was the largest, the lens was the thickest and the ocular axis was the shortest; in the control group, the corneal refractive power was the smallest, the lens was the thinnest, and the ocular axis was the longest. These parameters in the non-ROP group were between those in the two groups mentioned above (P < 0.05). The corneal refractive power was relatively stable at 3–8 years old in the three groups. The change in lens thickness was small in both the ROP group and the non-ROP group (P = 0.75, P = 0.06), and the lens became thinner in the control group (P < 0.001). The length of the ocular axis increased in the three groups. Preterm infants are more likely to develop myopia than full-term infants, and children with ROP are more likely to develop both myopia and astigmatism. Thicker lenses were the main cause of the high prevalence of myopia in premature infants with or without ROP.

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A Neuroectodermal Hypothesis of the Cause and Relationship of Myopia in Retinopathy of Prematurity

Abstract: Increased lens thickness in the absence of anterior segment arrest seems to be the major contributing factor for myopia in ROP.This change may be associated with altered neuroectodermal development in ROP.

Cited by 7 publications

References 18 publications

Lens power, cornea power and association with refractive error in children with moderate to high hyperopia

Lens power, cornea power and association with refractive error in children with moderate to high hyperopia

Refractive Status and Biometric Characteristics of Children With Familial Exudative Vitreoretinopathy

Refractive status and optical components in premature infants with and without retinopathy of prematurity: A 4- to 5-year cohort study

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