Retinal vascular changes in preterm infants: heart and lung diseases and plus disease

Area of Science:

• Ophthalmology
• Neonatology
• Pediatric Cardiology

Background:

• Preterm infants are susceptible to various systemic conditions including congenital heart disease (CHD), lung disease (pulmonary hypertension [PH] and bronchopulmonary dysplasia [BPD]), and retinopathy of prematurity (ROP).
• Retinal vascular morphology may reflect systemic vascular changes, but distinct patterns for these conditions are not well-established.

Purpose of the Study:

• To investigate and compare the retinal vascular features in preterm infants diagnosed with CHD, lung disease, and ROP with plus disease.
• To determine if distinct retinal vessel morphology can differentiate these clinical entities.

Main Methods:

• Retrospective review of medical records for preterm infants with CHD, lung disease, and ROP with plus disease.
• Computer-based software analysis of 25 representative retinal images per infant, measuring vessel diameter and tortuosity index.
• Categorization of infants into five groups based on clinical diagnoses.

Main Results:

• Analysis included 106 preterm infants (mean gestational age 30.5 weeks).
• Retinal vascular tortuosity without vasodilation was observed in infants with CHD and lung diseases.
• Venular diameter was significantly increased in the ROP with plus disease group compared to others (P=0.0022).
• Significantly less arteriolar and venular tortuosity was noted in bronchopulmonary dysplasia (BPD) compared to the ROP with plus disease group.

Conclusions:

• Retinal vascular tortuosity patterns may be specific to different systemic congestive conditions in preterm infants.
• These distinct vascular signatures could have potential therapeutic implications for managing these complex conditions.