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Association Between Retinal Microanatomy in Preterm Infants and 9-Month Visual Acuity
Kai R Seely1, Shwetha Mangalesh1, Liangbo L Shen1,2
1Department of Ophthalmology, Duke University School of Medicine, Durham, North Carolina.
JAMA Ophthalmology
|June 2, 2022
Summary
Preterm infants with thinner retinal nerve fiber layers (RNFL) across the papillomacular bundle (PMB) show poorer visual acuity (VA) at 9 months corrected age. Optical coherence tomography (OCT) evaluation of RNFL thickness can identify at-risk infants.
Area of Science:
- Ophthalmology
- Neonatology
- Developmental Biology
Background:
- Preterm infants often experience suboptimal visual acuity (VA) outcomes, even without detectable retinal abnormalities.
- Infant retinal microanatomy warrants investigation as a potential factor influencing visual development.
Purpose of the Study:
- To investigate the association between retinal microanatomy in preterm infants and their visual acuity at 9 months corrected age.
- To determine if specific retinal layer thicknesses correlate with visual outcomes in this population.
Main Methods:
- Prospective observational study involving preterm infants undergoing bedside optical coherence tomography (OCT) for retinal microanatomy assessment.
- Monocular grating visual acuity was measured at 9 months corrected age.
- Retinal layer thicknesses, including the retinal nerve fiber layer (RNFL) across the papillomacular bundle (PMB), were quantified and correlated with VA.
Main Results:
- Thinner RNFL thickness across the PMB was independently associated with poorer 9-month corrected visual acuity (logMAR VA).
- Prior treatment for retinopathy of prematurity (ROP) also correlated with poorer visual outcomes.
- No significant associations were found between inner nuclear layer, inner retina, or total retina thickness and VA.
Conclusions:
- RNFL thinning in preterm infants is linked to reduced visual acuity at 9 months corrected age, irrespective of other factors like birth weight or gestational age.
- OCT-based evaluation of RNFL thickness may serve as a valuable tool for identifying preterm infants at risk for poor vision.
