Retinal ganglion cell complex thickness at school-age, prematurity and neonatal stressors
Ana Ortueta-Olartecoechea1, Jose L Torres-Peña1, Alicia Muñoz-Gallego1
1Madrid University Hospital "12 de Octubre", Department of Ophthalmology, Madrid, Spain.
Insights
Prematurity is linked to thinner ganglion cell complex (GCC) layers in school-aged children. Neonatal factors like shock and corticosteroid therapy further reduce GCC thickness, highlighting the importance of considering birth history during eye exams.
Area of Science:
- Ophthalmology
- Neonatology
- Developmental Pediatrics
Background:
- Prematurity is a significant risk factor for various neurodevelopmental and visual impairments.
- The ganglion cell complex (GCC) thickness is a key indicator of retinal health and visual pathway integrity.
Purpose of the Study:
- To investigate the association between ganglion cell complex (GCC) thickness in early school-age children and their history of prematurity.
- To identify specific neonatal and postnatal factors that may influence GCC thickness in preterm children.
Main Methods:
- A cross-sectional study comparing very preterm children (gestational age < 32 weeks or birthweight < 1500g) with term-born children.
- Ganglion cell complex (GCC) thickness measured using optical coherence tomography (OCT) in children aged 4-8 years.
- Analysis of neonatal and postnatal clinical records, including gestational age, birthweight, and medical interventions.
Main Results:
- Preterm children exhibited significantly thinner GCC layers (ganglion cell layer and inner retinal nerve fiber layer) compared to term-born children.
- Lower gestational age and being small for gestational age were associated with reduced GCC thickness in preterm infants.
- Neonatal shock, severe brain lesions, and postnatal corticosteroid therapy were linked to additional thinning of GCC layers.
Conclusions:
- Reduced GCC thickness at school-age is associated with prematurity, with further thinning linked to specific neonatal complications.
- OCT examinations in school-aged children showing decreased GCC thickness warrant inquiry into a history of prematurity and related neonatal factors.
- These findings emphasize the long-term impact of neonatal health on retinal structure and the importance of comprehensive eye assessments for preterm infants.
Purpose:
To investigate the association between the ganglion cell complex (GCC) thickness at early school-age and prematurity and other neonatal factors.
Methods:
Cross-sectional study. The sample included very preterm children with gestational age (GA) below 32 weeks or birthweight below 1500 g enrolled in a follow-up program (n = 101) and a comparison group of term-born children (n = 49). Ganglion cell complex (GCC) thickness was measured at 4-8 years using high-quality optical coherence tomography (OCT) images. Data on neonatal and postnatal features were extracted from clinical records; analyses included mixed linear models.
Results:
Ganglion cell layer (GCL) and retinal nerve fiber layer (mRNFL) were thicker in term than in preterm born children (2.9 μm and 2.4 μm respectively, p < 0.001). Within the preterm group, lower GA was associated with a decrease in total GCL (0.7 μm per week, p < 0.001). Being small for GA was associated with further thinning in both layers (1.4 and 2.8 µm). Postnatal corticosteroids therapy and severe brain lesion were associated with thinning in the total GCL of 6 µm (p < 0.001) and 4.1 µm (p = 0.002), respectively, and shock was associated with thinning in total mRNFL of 6 µm (p < 0.001).
Conclusions:
Lower GA or birthweight are associated with thinning of GCC layers. When performing an OCT examination at school-age and a decrease in GCC thickness is observed, it may be relevant to ask about a history of prematurity, and further enquire about neonatal shock, postnatal corticosteroids therapy or severe brain lesion that are related to additional decrease in GCC thickness.
Related Concept Videos
01:20Anatomy of the Eyeball
01:22Photoreceptors and Visual Pathways