Characterization of Foveal Development in Treatment-Naïve Extremely Preterm Infants

Abstract

Objective To characterize and quantify foveal development in treatment-naïve extremely preterm infants using optical coherence tomography. Methods In this cross-sectional study, eyes treated for retinopathy of prematurity before imaging were excluded. Inner retinal thickness and outer retina thickness at foveal center and foveal rim were assessed. Extremely preterm (EPT, <28 weeks gestational age) eyes were compared with infants more than 28 weeks of gestation using a multivariable dimension reduction analysis (principal component analysis) and a bilinear factor mode analysis (partial least square discriminant analysis) to determine group intervariability. Further analyses were performed to investigate the effects of gestation on foveal development. Results Twenty-six infants born at gestational ages ranging from 22 to 39 weeks were imaged between 32 and 80 weeks postmenstrual age. A principal component analysis and partial least squares discriminant analysis revealed that the foveal inner retina thickness was the main difference between EPT infants and non-EPT infants. This difference was reflected by comparing their inner retinal thickness over time (32–80 weeks postmenstrual age), which revealed a sustained thicker foveal inner retina for EPT infants when compared with non-EPT infants. The foveal pit seemed to be shallower in EPT infants when compared with non-EPT infants. Conclusions Twenty-eight weeks of gestation seems to be a critical timepoint for foveal development; EPT infants had altered foveal inner retinal development throughout early postnatal development, which led to a thicker foveal inner retina and a shallower foveal pit soon after birth. Translational Relevance Measuring untreated foveal parameters informs about the effects of prematurity on the fovea and provides a baseline when comparing with post-treatment foveal development.

Visual outcomes and their association with grey and white matter microstructure in adults born preterm with very low birth weight

“…Our data are in line with the few existing studies investigating RNFL, such as the EPICure study that reported a thicker RNFL in A1 of the EDTRS grid in a group of 19-year-olds born extremely preterm compared to controls 6 . The results also coincide with findings of thicker central retinal layers with earlier gestational age in infants born extremely preterm 28 , 5 to -16-year-old children born preterm 29 . The centrifugal movement of inner retinal layers to the periphery and migration of outer photoreceptor layers towards the centre of the retina 30 occurs during late gestation and preterm birth therefore disrupt these processes 28 which can result in a thicker RNFL in the inner layers, as shown in this study.…”

Optical Coherence Tomography in Retinopathy of Prematurity

“…It has been reported that compared to term born infant, premature infant or ROP infant eyes usually has shallower foveal pit, retain inner retinal layers at foveal center, thinner outer retinal layers, and indistinctive external limiting membrane band and ellipsoid zone (Figure 1) [32][33][34].…”