Sex-Specific Differences in the Relationship Between Prematurity and Ocular Geometry.

Area of Science:

• Ophthalmology
• Developmental Biology
• Human Genetics

Background:

• Gestational age (GA) and birth weight (BW) are critical determinants of infant development.
• Ocular structures undergo significant development during gestation, influencing long-term visual health.
• Sex-based biological differences can impact developmental trajectories and health outcomes.

Purpose of the Study:

• To investigate sex-specific relationships between gestational age (GA) and birth weight (BW) percentile with ocular geometry in adults.
• To determine if sex modifies the association between GA/BW percentile and ocular parameters.

Main Methods:

• Prospective ophthalmic examination of 438 adults (aged 18-52) born preterm or at term.
• Uni- and multivariable linear regression analyses assessed associations between GA/BW percentile and ocular measures.
• Key ocular measures included central corneal thickness, corneal radius, anterior chamber depth, lens thickness, posterior segment length, and central foveal thickness.
• Sex-specific differences and effect modification by sex were analyzed.

Main Results:

• A negative association was found between higher GA and central foveal thickness in both females (B = -2.99) and males (B = -4.27).
• Multivariable analysis with effect modification showed that lower GA was associated with thicker central foveal thickness.
• A significant sex-by-GA interaction (B = 1.29, P = 0.04) indicated a more pronounced effect of GA on central foveal thickness in males.

Conclusions:

• A sex-specific correlation exists between lower GA and thicker central foveal thickness, highlighting divergent ocular developmental pathways.
• Thicker central foveal thickness in preterm-born individuals may impact adult visual acuity, particularly in males, and predispose to age-related diseases.
• Sex did not alter the association of GA or BW percentile with other evaluated ocular geometric parameters.