Critical Period for Foveal Fine Structure in Children With Regressed Retinopathy of Prematurity

Wang, Jingyun; Spencer, Rand; Leffler, Joel N.; Birch, Eileen E.

doi:10.1097/iae.0b013e318219e685

Cited by 64 publications

(64 citation statements)

References 22 publications

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“…5 OCT has revealed changes not evident on ophthalmoscopy, but these can be compatible with good visual acuity. 6,7,[9][10][11] Authors have questioned the possibility of a non-retinal aetiology for visual deficits, so examination of the choroid is warranted. 1 The choroid serves functions including metabolic support for the RPE and retina, acting as a heat sink, and absorbing excess light.…”

Section: Discussionmentioning

confidence: 99%

“…Studies have shown shallowing of the foveal depression, thickening of the central macula, and a continuity of inner retinal layers across the fovea in those born severely preterm, often despite normal macular appearance on ophthalmoscopy. [6][7][8][9][10][11][12][13][14] However, these macular changes evident on OCT are still compatible with good visual acuity. 6,7,[9][10][11] This has prompted authors to suggest that other factors might be contributory to the variation in vision seen in these patients.…”

Section: Introductionmentioning

confidence: 97%

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Choroidal thickness in regressed retinopathy of prematurity

Anderson

Ramasamy

Lythgoe

et al. 2014

Eye

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Purpose To compare choroidal thickness in patients with regressed retinopathy of prematurity (ROP) with healthy controls using enhanced depth imaging optical coherence tomography (EDI OCT) Methods Twenty-four children and young adults (41 eyes) with regressed ROPZstage 3 had undergone EDI OCT with Spectralis FD-OCT as part of their clinical record. Their refraction, best-corrected visual acuity, and ophthalmoscopic findings were recorded. Corresponding data was collected prospectively from 33 healthy controls (58 eyes) who had been born at term. Choroidal thickness was measured independently by two observers subfoveally and at 1500 mm nasal and temporal to the fovea using EDI OCT. Results Mean subfoveal choroidal thickness, adjusted for refraction, was 271.1 mm (95% CI, 247.8-294.5) in the ex-ROP group, which was significantly thinner than 327.4 mm (95% CI, 293.8-360.9) in controls (P ¼ 0.008). Similarly, mean adjusted temporal choroidal thickness was 257.2 mm (95% CI, 240.2-274.2) in ex-ROP's vs 320.5 mm (95% CI, 288.6-352.3) in controls (P ¼ 0.001). There was no statistically significant difference in the nasal measurement. In the ex-ROP group, there was no significant correlation between subfoveal choroidal thickness and gestational age (r s ¼ 0.16, P ¼ 0.46) or birthweight (r s ¼ 0.03, P ¼ 0.90). In eyes without copathology in addition to regressed ROP (29 eyes, 19 patients), there was no significant correlation between subfoveal choroidal thickness and visual acuity. Conclusions Our findings of thinner subfoveal and temporal macular choroidal thickness in regressed ROP support the case for choroidal involvement in the pathogenesis of this condition.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 97%

Choroidal thickness in regressed retinopathy of prematurity

Anderson

Ramasamy

Lythgoe

et al. 2014

Eye

View full text Add to dashboard Cite

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“…Because these factors have complicated relations with each other, it might be hard to find significant factor for the poor visual acuity in preterm patients. Although recent studies showed that retinal layer thickness at the fovea was not associated with visual acuity in preterm children, 8,24,25 Wang et al 1 reported that peripapillary RNFL thickness on the temporal side of the disc is related with visual acuity. Peripapillary RNFL is closely correlated with multiple visual deficits including visual field defect, low-contrast sensitivity, and abnormal electrophysiology results, as well as visual acuity in patients with various disease affecting the optic nerve.…”

Section: Variablementioning

confidence: 96%

“…Interestingly, although statistically significant differences in RNFL thicknesses between preterm and full-term children were observed in the average global RNFL thickness and in sectors including superior and nasal sides; the largest thinning of the mean RNFL thickness in preterm children was observed in the nasal sector, statistically significant correlations between baseline factors and RNFL thickness was mainly observed in RNFL thicknesses in the temporal sector. Wang et al 1,8 hypothesized that such abnormalities in the spatial profile of RNFL would be present based on abnormal inner retinal layers overlaying the fovea in preterm children. Recent studies have revealed that preterm children have thicker central maculae than children born at term, regardless of the presence of ROP.…”

Section: Variablementioning

confidence: 99%

“…6,9,10 Another recent study has shown that premature birth is associated with the failure of multiple retinal layers to migrate away from the fovea, resulting in increased foveal thickness in patients with ROP. 8 This immature and not fully migrated retinal layers could directly contribute to the increased thickness of peripapillary RNFL thicknesses in the temporal sector. It is also possible that this temporal thickening and thinning of other sectors in preterm children compared with full-term controls are reflections of immature development of neurovascular structures around the optic disc itself.…”

Section: Variablementioning

confidence: 99%

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Retinal nerve fiber layer thickness in prematurity is correlated with stage of retinopathy of prematurity

2015

Eye

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Purpose To compare retinal nerve fiber layer (RNFL) thickness profiles between preterm and full-term children and to investigate factors affecting the RNFL distribution in preterm children.Methods We performed Spectral domain optical coherence tomography (SD-OCT) peripapillary RNFL circular scan centered on the optic disc in 50 premature and 58 full-term children. RNFL thickness profiles were compared between preterm and fullterm children using a linear regression model. Among preterm patients in this study, 20 patients previously received laser treatment for severe retinopathy of prematurity (ROP).Results Global average, nasal, and superior disc RNFL thickness profiles were significantly smaller in preterm children (92.70 ± 16.57 μm, 56.02 ± 17.04 μm, and 108.74 ± 27.36 μm, respectively) compared with full-term children (101.63 ± 9.21 μm, P = 0.006, 69.14 ± 14.15 μm, Po0.001, and superior, 129.11 ± 18.14 μm, Po0.001, respectively). Multivariable analysis revealed that ROP stage was inversely correlated with nasal RNFL thickness (P = 0.010).Conclusions Our SD-OCT data demonstrate decreased global average, nasal, and superior disc RNFL thicknesses in preterm children. ROP stage was inversely correlated with nasal RNFL thickness. Further studies are needed to better understand the association between these structural changes and visual functions in preterm children.

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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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Critical Period for Foveal Fine Structure in Children With Regressed Retinopathy of Prematurity

Abstract: Preterm birth before 28 weeks of gestational age was associated with a failure of the inner retinal layers to migrate away from the fovea, resulting in increased foveal thickness.

Cited by 64 publications

References 22 publications

Choroidal thickness in regressed retinopathy of prematurity

Choroidal thickness in regressed retinopathy of prematurity

Retinal nerve fiber layer thickness in prematurity is correlated with stage of retinopathy of prematurity

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

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