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Macular development in the premature infant
Insights
Macular development in premature infants was classified, aiding gestational age estimation. Retinopathy of prematurity was linked to a two-week delay in macular development, suggesting a direct insult.
Area of Science:
- Ophthalmology
- Neonatology
- Developmental Biology
Background:
- The macula's development is crucial for visual acuity.
- Assessing gestational age in premature neonates is clinically important.
- Retinopathy of prematurity (ROP) is a significant concern in preterm infants.
Purpose of the Study:
- To establish a classification system for the developing ophthalmoscopic appearance of the macula in premature neonates.
- To correlate macular development with gestational age.
- To investigate the impact of retinopathy of prematurity on macular development.
Main Methods:
- Retinal examinations were performed on 129 premature neonates.
- A sequential classification of macular development was established from 34 to 42 weeks of gestational age.
- Macular development in infants with and without retinopathy of prematurity was compared.
Main Results:
- A normal sequence of macular development was observed, enabling gestational age estimation.
- Infants with or developing retinopathy of prematurity showed a statistically significant two-week delay in later-stage macular development.
- This delay suggests a potential direct macular insult in retinopathy of prematurity.
Conclusions:
- The ophthalmoscopic appearance of the developing macula provides a reliable method for estimating gestational age in premature neonates.
- Retinopathy of prematurity is associated with delayed macular development.
- This study provides evidence for a direct macular insult in retinopathy of prematurity.
Abstract:
To classify the ophthalmoscopic appearance of the developing macula, I performed retinal examinations on 129 premature neonates. In normal infants, the classification ranged from 34 weeks of gestational age when pigment was first evident in the macula, through the development of the annular ring reflex of the macula and foveolar reflex, to a mature (adult-appearing) macula at 42 weeks. This sequence allowed the observer to estimate the gestational age of the older premature neonate from the appearance of the macular area. Babies who had, or subsequently developed, retinopathy of prematurity showed a statistically significant two-week delay in macular development in the later stages. This may be the first evidence of a direct macular insult in retinopathy of prematurity.