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Birth weight and optic nerve head parameters
Chameen Samarawickrama1, Son C Huynh, Gerald Liew
1Centre for Vision Research, Department of Ophthalmology and Westmead Millennium Institute, University of Sydney, New South Wales, Australia.
Insights
Low birth weight and smaller fetal growth are linked to larger optic cup-to-disc ratios in 12-year-olds. This suggests fetal growth restriction may impact optic nerve health and glaucoma risk.
Area of Science:
- Ophthalmology
- Pediatric Ophthalmology
- Public Health
Background:
- The relationship between intrauterine growth and optic nerve head parameters is not fully understood.
- Assessing optic disc parameters in children can provide insights into long-term ocular health.
- Fetal growth restriction may have lasting effects on ocular development.
Purpose of the Study:
- To investigate the association between birth measurements (birth weight, length, head circumference) and optic disc parameters in children.
- To evaluate optic disc and cup diameters, and their ratio using optical coherence tomography (OCT).
- To determine if markers of intrauterine growth impact optic nerve head morphology.
Main Methods:
- Cross-sectional analysis of 2134 children aged 12 from the Sydney Childhood Eye Study.
- Optical coherence tomography (OCT) was used to measure optic disc and cup parameters.
- Birth measurements were obtained from health records; logistic and mixed models were used for analysis.
Main Results:
- Low birth weight was associated with decreased vertical disc diameter and increased cup diameter and cup/disc ratio.
- Adjusted analyses confirmed birth weight's association with optic disc and cup size, and cup/disc ratio.
- Smaller birth length and head circumference were also linked to larger cup/disc ratios.
Conclusions:
- Reduced fetal growth, indicated by low birth weight, length, or head circumference, is associated with larger optic cup-to-disc ratios at age 12.
- Fetal growth restriction may negatively affect optic nerve head development.
- These findings highlight a potential link between early growth and future risk of glaucomatous optic neuropathy.
Purpose:
To assess the relationship of birth weight, birth length, and head circumference as proxy markers of intrauterine growth, cup/disc ratio, and other optic disc parameters measured using optical coherence tomography (OCT).
Design:
Population-based cross sectional analysis.
Participants:
The Sydney Childhood Eye Study examined 2353 primarily 12-year-old children from 21 randomly selected secondary schools during 2003 to 2005.
Methods:
Of 2353 children examined, 2134 (90.7%) had OCT scans (Zeiss Stratus OCT, Carl Zeiss Meditec, Dublin, CA) and are included in this study. The "fast" optic disc scan protocol was used. Birth weight, birth length, and head circumference were ascertained from health records. Height and weight were measured using standardized protocols, body mass index (BMI) was defined as weight (kilograms)/ height squared (meters), and sociodemographic information was collected in a questionnaire completed by parents. Low birth weight was defined as birth weight
Main Outcome Measures:
Vertical optic disc and optic cup diameters, and cup/disc ratio.
Results:
Children of low birth weight had decreased vertical disc diameter, increased cup diameter, and increased cup/disc ratio by 30 microm (P = 0.009), 44 microm (P = 0.004), and 0.03 (P<0.0001), respectively. After adjusting for age, gender, ethnicity, height, axial length, and BMI, birth weight remained positively associated with vertical optic disc diameter and inversely associated with both vertical optic cup diameter and vertical cup/disc ratio (each kilogram increase was associated with a 0.0133-mm larger mean disc diameter; P = 0.04; a 0.0203-mm smaller mean cup diameter; P = 0.02; and a 0.0136 reduction in mean cup/disc ratio; P = 0.002). These associations were not present in children with gestational age less than 33 weeks. Smaller birth length and head circumference were similarly associated with larger cup/disc ratio.
Conclusions:
Low birth weight, short birth length, and small head circumference at birth were associated with larger cup/disc ratio in children aged 12 years. Our findings suggest that fetal growth restriction could adversely influence optic nerve head parameters. This may have implications for future risk of glaucomatous optic neuropathy.
Financial Disclosure(S):
The author(s) have no proprietary or commercial interest in any materials discussed in this article.
