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Published on: May 26, 2023
Morphological characteristics of early- versus late-onset macular edema in preterm infants
Shwetha Mangalesh1, Brittany M Wong1, Xi Chen1
1Department of Ophthalmology, Duke University School of Medicine, Durham, North Carolina.
Insights
Infants with early-onset macular edema show more severe foveal changes. Late-onset edema in preterm infants may indicate neurological injury due to parafoveal cystoid spaces.
Area of Science:
- Ophthalmology
- Neonatology
- Pediatric Neurology
Background:
- Macular edema is a concerning condition in preterm infants.
- Understanding the timing and morphology of edema is crucial for diagnosis and prognosis.
Purpose of the Study:
- To compare the morphological characteristics of early-onset versus late-onset macular edema in preterm infants.
- To explore potential associations between edema morphology and underlying causes, including neurological injury.
Main Methods:
- Comparative analysis of macular images from preterm infants.
- Categorization of edema based on onset: early (≤33 weeks postmenstrual age) and late (≥36 weeks postmenstrual age).
Main Results:
- Early-onset edema presented with more severe morphology, including foveal bulging and elongated cystoid spaces.
- Late-onset edema was characterized by small cystoid spaces predominantly outside the foveal center.
- Parafoveal small cystoid spaces in late-onset edema may suggest a link to neurological injury.
Conclusions:
- Morphological variations in macular edema are significant indicators of underlying pathologies in preterm infants.
- The distinct presentations of early- and late-onset edema warrant further investigation into their specific etiologies and clinical implications.
Abstract:
Macular images of infants with early-onset edema (occurring at or before 33 weeks' postmenstrual age [PMA]) and infants with late-onset edema (at or after 36 weeks' PMA) were compared. At first appearance, early-onset edema has a more severe morphology, with foveal bulging and elongated cystoid spaces than late-onset edema, which presents as small cystoid spaces outside the foveal center. Morphological variations may be an indicator of the underlying cause of edema in preterm infants. The presence of mostly parafoveal small cystoid spaces in the late-onset edema group may be suggestive of an association with neurological injury.
