Retinal structural changes in preterm children without retinopathy of prematurity

Area of Science:

• Ophthalmology
• Developmental Biology
• Retinal Imaging

Background:

• Retinopathy of prematurity (ROP) is a leading cause of vision impairment in premature infants.
• Understanding the long-term structural changes in the retina of preterm children without ROP is crucial for accurate diagnosis and management.
• Spectral domain-optical coherence tomography (SD-OCT) allows for detailed analysis of retinal layer thickness.

Purpose of the Study:

• To compare the thickness of all retinal layers between full-term and preterm children without a history of ROP.
• To identify specific retinal layers and regions affected by preterm birth in the absence of ROP.

Main Methods:

• A cross-sectional study involving two groups: preterm children (gestational age < 37 weeks) without ROP and healthy full-term children.
• Ophthalmic examination including SD-OCT for retinal layer thickness measurement in nine ETDRS areas.
• Demographic, gestational, and birth data were collected, and generalized additive regression models were used for analysis.

Main Results:

• The preterm group exhibited significantly reduced retinal thickness in the total retina nasal outer sector, ganglion cell layer (GCL), and inner plexiform layer (IPL) compared to the full-term group.
• Specific areas of significant thinning included GCL temporal outer, GCL superior outer, IPL temporal outer, and IPL superior outer.
• Birth head circumference showed a non-linear association with retinal thickness, influencing the models.

Conclusions:

• Preterm children without ROP demonstrate structural retinal alterations, primarily affecting the GCL and IPL in macular outer regions.
• These findings highlight the importance of considering gestational history when evaluating retinal structure in children.
• Unrecognized retinal changes in preterm individuals may lead to unnecessary investigations later in life.