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The long-term influence of perinatal factors on macular morphology and vessel density in preterm children
Agnieszka Czeszyk1, Wojciech Hautz1, Dorota Bulsiewicz2
1Department of Ophthalmology, The Children's Memorial Health Institute, 04-730 Warsaw, Poland.
Insights
Retinopathy of prematurity (ROP) and other neonatal factors significantly impact retinal development in preterm children. Prenatal factors also play a crucial role in long-term retinal morphology and vascularity.
Area of Science:
- Ophthalmology
- Neonatology
- Developmental Biology
Background:
- Increased survival of extremely preterm infants is linked to higher risks of retinopathy of prematurity (ROP).
- ROP and its sequelae involve significant retinal changes affecting long-term vision.
- Understanding these changes is crucial for managing preterm children's eye health.
Purpose of the Study:
- To investigate the influence of perinatal characteristics on the macula's morphology and retinal vascularity in preterm children.
- To identify specific neonatal and prenatal factors associated with retinal structural and vascular alterations.
- To correlate clinical outcomes with detailed OCTA findings in a cohort of preterm children.
Main Methods:
- Prospective assessment of 123 preterm children at a median age of 10.5 years.
- Optical coherence tomography angiography (OCTA) was used to analyze macular structure and vascularity.
- Key parameters included foveal thickness, foveal avascular zone (FAZ) size, vessel density, and central choroidal thickness (CCT).
Main Results:
- Children with ROP exhibited smaller FAZ, increased foveal thickness, and higher vessel density.
- ROP and laser treatment were associated with increased foveal thickness.
- History of sepsis and treated ROP correlated with thinner central choroidal thickness (CCT).
- Pregnancy bleeding was linked to higher superficial foveal vessel density and smaller FAZ.
Conclusions:
- Neonatal factors significantly shape retinal development and vascularization in preterm children.
- Prenatal factors, such as pregnancy bleeding, also influence long-term retinal morphology.
- Comprehensive assessment considering both prenatal and neonatal factors is vital for preterm infants' eye care.
Background:
Increased survival rate of extremely preterm children is associated with a higher risk of retinopathy of prematurity (ROP) and long-term sequelae, which implicate retinal changes.
Purpose:
To assess an influence of perinatal characteristics on morphology and retinal vascularity of the macula in preterm children.
Methods:
A cohort of 123 preterm children at the age of 10.5 years (IQR: 8.12-12.77) was prospectively assessed. Optical coherence tomography angiography (OCTA) was performed using RTVueXR Avanti. Foveal thickness, parafoveal thickness, size of foveal avascular zone (FAZ), superficial and deep vessel density, central choroidal thickness (CCT) were analyzed. The associations between OCTA results and perinatal factors, including the presence of ROP and therapy requirements were assessed in preterm children.
Results:
Significantly smaller FAZ, higher foveal thickness and vessel density were noted in children with ROP, Respiratory Distress Syndrome, Bronchopulmonary Dysplasia, required erythropoietin, transfusion or steroids. Foveal thickness was increased in children with ROP (p < 0.001) and following laser treatment (p < 0.05). Thinner CCT was noted in children with a history of sepsis (p < 0.05) and ROP required treatment (p < 0.05). Pregnancy bleeding was associated with higher superficial foveal vessel density (p < 0.05) and smaller FAZ (p < 0.05).
Conclusion:
Neonatal factors have a huge impact on retinal development, but the role of prenatal factors should not be neglected in preterm children.
