Retinal ganglion cell complex thickness at school‐age, prematurity and neonatal stressors

Abstract

Purpose: To investigate the association between the ganglion cell complex (GCC) thickness at early school-age and prematurity and other neonatal factors. Methods: Cross-sectional study. The sample included very preterm children with gestational age (GA) below 32 weeks or birthweight below 1500 g enrolled in a follow-up program (n = 101) and a comparison group of term-born children (n = 49). Ganglion cell complex (GCC) thickness was measured at 4-8 years using high-quality optical coherence tomography (OCT) images. Data on neonatal and postnatal features were extracted from clinical records; analyses included mixed linear models. Results: Ganglion cell layer (GCL) and retinal nerve fiber layer (mRNFL) were thicker in term than in preterm born children (2.9 lm and 2.4 lm respectively, p < 0.001). Within the preterm group, lower GA was associated with a decrease in total GCL (0.7 lm per week, p < 0.001). Being small for GA was associated with further thinning in both layers (1.4 and 2.8 µm). Postnatal corticosteroids therapy and severe brain lesion were associated with thinning in the total GCL of 6 µm (p < 0.001) and 4.1 µm (p = 0.002), respectively, and shock was associated with thinning in total mRNFL of 6 µm (p < 0.001). Conclusions: Lower GA or birthweight are associated with thinning of GCC layers. When performing an OCT examination at school-age and a decrease in GCC thickness is observed, it may be relevant to ask about a history of prematurity, and further enquire about neonatal shock, postnatal corticosteroids therapy or severe brain lesion that are related to additional decrease in GCC thickness.

Ganglion cell complex thickness with spectral domain optical coherence tomography and correlations in a normative pediatric South Asian cohort

“…Evaluation of healthy children also differentiates their retinal structure from preterm children's retinas and several studies on the latter have come forward where a thinned GCC has been linked to prematurity and may be associated with their visual impairment (Czeszyk et al, 2022; Lee, Chang, et al, 2018; Ortueta‐Olartecoechea et al, 2021). However, the GCC is thicker in children with retinopathy of prematurity as noted in one study, and needs careful assessment and monitoring for glaucoma development in these children (Lee, Chang, et al, 2018).…”