Assessment of Retinal Nerve Fiber Layer Thickness in Healthy, Full-Term Neonates

Rothman, Adam L.; Sevilla, Monica; Freedman, Sharon F.; Tong, Amy; Tai, Vincent; Tran-Viet, Du; Farsiu, Sina; Toth, Cynthia A.; El-Dairi, Mays

doi:10.1016/j.ajo.2015.01.017

Cited by 27 publications

(33 citation statements)

References 55 publications

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“…The healthy, term cohort has been previously described. 26 Term infants in the newborn nursery were eligible if born between 37 and 42 weeks post-menstrual age and deemed clinically stable to undergo SD-OCT imaging. Very preterm infants at the Duke University intensive care nursery were eligible for SD-OCT imaging following clinically indicated retinopathy of prematurity (ROP) screening examination if deemed clinically stable at the time of eye examination by the intensive care nursery pediatric team.…”

Section: Methodsmentioning

confidence: 99%

“…20-26 Correlations have been reported between these retinal and optic nerve metrics of development, and the broader brain health of preterm infants. For example, subclinical macula edema has been identified as an ophthalmologic biomarker of poor neurodevelopment in very preterm infants.…”

Section: Introductionmentioning

confidence: 99%

“…23 Furthermore, average RNFL thickness has been measured reproducibly in healthy, term neonates as another metric of central nervous system tissue. 26 In this study we aim to evaluate the relationship of ganglion cell anatomy to brain health and development by assessing RNFL thickness measurements ,and to compare these data to standardized quantification of magnetic resonance imaging (MRI) brain lesion burden 27 and neurodevelopmental outcomes 28 in very preterm infants.…”

Section: Introductionmentioning

confidence: 99%

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Thinner Retinal Nerve Fiber Layer in Very Preterm Versus Term Infants and Relationship to Brain Anatomy and Neurodevelopment

Rothman

Sevilla

Mangalesh

et al. 2015

American Journal of Ophthalmology

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Purpose To assess retinal nerve fiber layer (RNFL) thickness at term-equivalent age in very preterm (<32 weeks gestational age) versus term-born infant cohorts, and compare very preterm infant RNFL thickness with brain anatomy and neurodevelopment. Design Cohort study. Methods RNFL was semi-automatically segmented (one eye per infant) in 57 very preterm and 50 term infants with adequate images from bedside portable, handheld spectral domain optical coherence tomography (Bioptigen, Inc., Research Triangle Park, NC) imaging at 37-42 weeks postmenstrual age. Mean RNFL thickness was calculated for the papillomacular bundle (−15° to + 15°) and temporal quadrant (−45° to +45°) relative to the fovea-optic nerve axis. Brain magnetic resonance imaging (MRI) scans clinically obtained in 26 very preterm infants were scored for global structural abnormalities by an expert masked to data except for age. Cognitive, language, and motor skills were assessed with Bayley Scales of Infant and Toddler Development-III (Pearson, San Antonio, TX) in 33 of the very preterm infants at 18-24 months corrected age. Results RNFL was thinner for very preterm versus term infants at the papillomacular bundle ([mean ± standard deviation] 61 ± 17 versus 72 ± 13 μm, p<0.001) and temporal quadrant (72 ± 21 versus 82 ± 16 μm, p=0.005). In very preterm infants, thinner papillomacular bundle RNFL correlated with higher global brain MRI lesion burden index (R2=0.35, p=0.001) and lower cognitive (R2=0.18, p=0.01) and motor (R2=0.17, p=0.02) scores. Relationships were similar for temporal quadrant. Conclusions Thinner RNFL in very preterm infants relative to term-born infants may relate to brain structure and neurodevelopment.

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Section: Methodsmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Thinner Retinal Nerve Fiber Layer in Very Preterm Versus Term Infants and Relationship to Brain Anatomy and Neurodevelopment

Rothman

Sevilla

Mangalesh

et al. 2015

American Journal of Ophthalmology

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“…Rothman et al27,28 published video links to bedside imaging in the NICU and imaging in the clinic 28. Imaging is first centered on the macula, with a single volume of macula, then a volume across optic nerve and preferably a volume containing both macula and the optic nerve to allow one to draw an organizing axis from optic nerve to fovea 29. These volumes, typically 60–75 scans per volume with 600–900 A scans per B scans covering an area of ~6–7 × 6–7 mm, are useful to extract central foveal scan and to segment for layers such as retinal nerve fiber layer (RNFL) 28,29…”

Section: Optical Coherence Tomographymentioning

confidence: 99%

“…Users then manually mark the center of the optic nerve and fovea to create an organizing axis and then can calculate the average RNFL thickness at any radial distance from the center of the optic nerve across an arc of any specified degree. This method has provided a normative dataset of mean RNFL thickness in healthy, term infants imaged prior to discharge from the nursery 29. This same methodology has since been applied to very preterm infants and validated as a way to reproducibly measure RNFL over time in this vulnerable population.…”

Section: Optic Nerve and Retinal Nerve Fiber Layermentioning

confidence: 99%

Optical coherence tomography of the preterm eye: from retinopathy of prematurity to brain development

Rothman

Mangalesh

Chen

et al. 2016

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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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Association Between Retinal Microanatomy in Preterm Infants and 9-Month Visual Acuity

et al. 2022

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IMPORTANCEPreterm 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 PARTICIPANTSThis 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 MEASURESPresence 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. RESULTSThe 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 RELEVANCEIn 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 microanatom...

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Assessment of Retinal Nerve Fiber Layer Thickness in Healthy, Full-Term Neonates

Cited by 27 publications

References 55 publications

Thinner Retinal Nerve Fiber Layer in Very Preterm Versus Term Infants and Relationship to Brain Anatomy and Neurodevelopment

Thinner Retinal Nerve Fiber Layer in Very Preterm Versus Term Infants and Relationship to Brain Anatomy and Neurodevelopment

Optical coherence tomography of the preterm eye: from retinopathy of prematurity to brain development

Association Between Retinal Microanatomy in Preterm Infants and 9-Month Visual Acuity

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