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Optic nerve morphology may reveal adverse events during prenatal and perinatal life--digital image analysis
1Department of Ophthalmology, Institute of Clinical Neuroscience, Sahlgrenska University Hospital/East, Göteborg, Sweden.
Insights
Optic nerve morphology in children with prenatal/perinatal conditions reveals brain lesions and damage timing. Digital image analysis helps understand these ocular and central nervous system connections.
Area of Science:
- Ophthalmology
- Neurology
- Pediatrics
Background:
- Prenatal and perinatal adverse events can cause various neurological conditions in children.
- Optic nerve and retinal vessel morphology may reflect underlying brain pathology.
Purpose of the Study:
- To evaluate optic nerve morphology in children with prenatal/perinatal adverse events.
- To correlate optic nerve morphology with brain lesions, etiology, and timing of damage.
Main Methods:
- Digital image analysis of fundus photographs.
- Comparison of patient groups (preterm, fetal alcohol syndrome, periventricular leukomalacia, septo-optic dysplasia) with a healthy reference group.
Main Results:
- Preterm infants without brain lesions had normal optic disks but abnormal retinal vasculature.
- Periventricular leukomalacia was associated with enlarged optic cups.
- Fetal alcohol syndrome showed subnormal optic disk area and vessel tortuosity.
- Septo-optic dysplasia presented with reduced optic disk area and isolated venous tortuosity.
Conclusions:
- Optic nerve morphology differences correlate with the etiology and timing of prenatal/perinatal adverse events.
- Digital image analysis is a valuable tool for studying optic nerve and retinal vessel morphology in relation to central nervous system pathology.
Objective:
To evaluate optic nerve morphology in children with various conditions caused by adverse events during prenatal and/or perinatal life and to investigate whether optic nerve morphology can reveal brain lesions associated with these conditions, as well as provide insight into the etiology and timing of the prenatal and perinatal damage.
Methods And Patients:
A digital image analysis technique was used to analyze fundus photographs. One hundred healthy Swedish individuals of various ages from childhood to adolescence constituted a reference group. The following patient groups were chosen to represent various clinical conditions affecting the newborn or fetus at different stages of development: children born preterm (N = 39), children with fetal alcohol syndrome (FAS [N = 16]), children with periventricular leukomalacia (PVL [N = 17]), and children with septo-optic dysplasia (SOD [N = 6]).
Results:
Preterm children without known brain lesions demonstrated normal optic disk morphology but abnormal retinal vascular pattern; children born preterm with an acquired brain lesion late in gestation (PVL) demonstrated normal disk size with enlarged cups in addition to the abnormal vascular pattern. Children with prenatal alcohol exposure (FAS) had a subnormal optic disk area with increased tortuosity of both arteries and veins, whereas children born at term with an early acquired brain lesion (SOD) had a markedly reduced optic disk area with isolated tortuosity of the retinal veins.
Conclusions:
Evaluation of optic nerve morphology, by digital image analysis, demonstrated that differences in ocular fundus morphology were correlated with differences in etiology and timing of the adverse event occurring in prenatal and perinatal life. In addition, digital image analysis may be a helpful tool for understanding variations in optic nerve and retinal vessel morphology and their relationship with central nervous pathology.