Ocular fundus abnormalities in children born before 29 weeks of gestation: a population-based study
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A Hellström1, A L Hård, E Svensson
1Department of Clinical Neuroscience, Queen Silvia Children's Hospital, Göteborg, Sweden. ann.hellstrom@medfak.gu.se
Insights
Very preterm birth is linked to smaller optic discs and abnormal retinal vessels in school-aged children. These findings highlight the impact of prematurity on ocular development, with potential long-term implications.
Area of Science:
- Ophthalmology
- Neonatology
- Developmental Biology
Background:
- Preterm birth is associated with significant neurological and vascular complications.
- The long-term effects of extreme prematurity on ocular structures require further investigation.
Purpose of the Study:
- To assess the influence of very preterm birth on optic disc and retinal vessel morphology in school-aged children.
- To identify potential long-term ocular consequences of extreme prematurity.
Main Methods:
- Prospective, population-based study of 50 very preterm children (gestational age 24-28 weeks).
- Ocular fundus examination including ophthalmoscopy and digital image analysis of fundus photographs.
- Evaluation of optic nerve and retinal vessel morphology.
Main Results:
- Significantly smaller optic disc and rim areas were observed in very preterm children compared to controls.
- Abnormal retinal vascular patterns were common in preterm children, irrespective of retinopathy of prematurity history.
- A smaller rim area was associated with early signs of brain lesions.
Conclusions:
- Very preterm birth leads to reduced optic disc and rim areas and altered retinal vasculature.
- These findings demonstrate a clear impact of preterm birth on ocular structure development.
- The long-term clinical significance of these ocular changes warrants further study.
Purpose:
Preterm birth has been found to be associated with increased morbidity of the central nervous and vascular tissues. To investigate the influence of preterm birth on the optic disc and retinal vessels, we examined the ocular fundus in school-aged children born very preterm.
Methods:
A prospective, population-based study was performed in 50 very preterm children (median age 7 years, range 5-9 years) with a median gestational age at birth of 27 weeks (range 24-28 weeks) and a median birth weight of 1055 g (range 450-1520 g). The ocular fundus was examined by ophthalmoscopy in 50 children, and the optic nerve and retinal vessel morphology was evaluated by digital image analysis of ocular fundus photographs in 45 of these children.
Results:
The median optic disc area was significantly smaller (p = 0.0002) in the preterm children compared with a reference group. There was no difference in cup area and, consequently, the rim area was significantly smaller (p = 0.0002) in the preterm children. Children with early signs of brain lesions commonly had a rim area below the median of the reference group. Preterm children also commonly had an abnormal retinal vascular pattern that was independent of a previous history of retinopathy of prematurity.
Conclusion:
Very preterm birth was associated with subnormal optic disc and rim areas and an abnormal vascular pattern. The findings clearly demonstrate the effect of preterm birth on the development of these structures. The long term clinical prognosis of these findings has yet to be determined.
