Related Experiment Video
Updated: May 13, 2025
Monitoring Dynamic Growth of Retinal Vessels in Oxygen-Induced Retinopathy Mouse Model
Published on: April 2, 2021
Fetal Growth Restriction Is Associated With Altered Optic Nerve Head Morphology in Term-Born Children and Adolescents
Achim Fieß1, Sandra Gißler1, Stephanie Grabitz1
1Department of Ophthalmology, University Medical Center of the Johannes Gutenberg University Mainz, Mainz, Germany.
Insights
Severe fetal growth restriction in children is linked to thinner optic nerve fiber layers, potentially indicating reduced neuronal reserve. This finding may suggest an increased risk for abnormal neurodevelopment.
Area of Science:
- Ophthalmology
- Neuroscience
- Developmental Biology
Background:
- Restricted fetal growth is a known risk factor for impaired neurodevelopment.
- The impact of fetal growth variations on the optic nerve head (ONH) morphology in children is not fully understood.
Purpose of the Study:
- To investigate the effects of fetal growth restriction and overgrowth on ONH morphology in term-born children and adolescents.
- To correlate ONH parameters with perinatal factors.
Main Methods:
- Retrospective cohort study with prospective ophthalmologic examination of 375 children (4-17 years).
- Participants grouped by birth weight percentile for gestational age: severe/moderate fetal growth restriction, appropriate for gestational age (AGA), and moderate/severe fetal overgrowth.
- Evaluated optic nerve head parameters including peripapillary retinal nerve fiber layer (pRNFL) thickness, minimal rim width (MRW), Bruch's membrane opening (BMO), and vertical cup-to-disc ratio (vCDR) using spectral-domain optical coherence tomography and fundus photography.
- Analyses adjusted for age, sex, and axial length.
Main Results:
- Severe fetal growth restriction was associated with thinner global pRNFL thickness compared to the AGA group (P=0.03).
- Moderate fetal growth restriction was associated with thinner MRW (P<0.001).
- Birth weight percentile correlated with vertical cup-to-disc ratio (P=0.02).
- No consistent association found between altered fetal growth and BMO.
Conclusions:
- Severe fetal growth restriction impacts ONH morphology in term-born children and adolescents.
- This may suggest a reduction in neuronal reserve.
- Potentially indicates an elevated risk for abnormal neurodevelopment.
Purpose:
Restricted fetal growth is associated with impaired neurodevelopment in childhood. We examined the effects of fetal growth restriction, fetal overgrowth, and other perinatal parameters on optic nerve head (ONH) morphology in term-born children and adolescents.
Methods:
This retrospective cohort study with a prospective ophthalmologic examination included full-term born children aged 4 to 17 years who were grouped according to their birth weight correlated to gestational age (GA). We formed the following groups: severe fetal growth restriction (<3rd birth weight [BW] percentile, group 1), moderate fetal growth restriction (BW percentile 3rd to <10th, group 2), appropriate for gestational age (AGA, 10th-90th BW percentile, group 3, control group), moderate fetal overgrowth (>90th-97th BW percentile, group 4), and severe fetal overgrowth (>97th percentile, group 5). The participants underwent spectral-domain optical coherence tomography and fundus photography to evaluate the peripapillary retinal nerve fiber layer (pRNFL) thickness, minimal rim width (MRW), Bruch's membrane opening (BMO), and vertical cup-to-disc ratio (vCDR), focusing on their relationship to perinatal factors like nutritional status, GA, maternal smoking, and maternal breastfeeding. The relationships between the ONH parameters and perinatal factors were adjusted for variables such as age, sex, and axial length.
Results:
This study included 732 eyes of 375 participants (mean age of 11.4 ± 3.71 years, 193 female subjects). Multivariable regression analyses showed an association between a thinner global pRNFL thickness in the participants with severe fetal growth restriction (B = -4.95; 95% confidence interval [CI], -9.43 to -0.47 µm; P = 0.03) compared to the reference AGA group. Furthermore, an association with a thinner MRW was found in the children born with moderate fetal growth restriction (B = -32.46; 95% CI, -51.52 to -13.40 µm; p < 0.001). BW percentile was associated with median vCDR (B = -0.001; 95% CI, -0.002 to 0.00; P = 0.02). No consistent association was observed between altered fetal growth and BMO.
Conclusions:
Severe fetal growth restriction appears to affect the optic nerve head in term-born children and adolescents, suggesting a possible reduction in neuronal reserve, and may indicate a potentially elevated risk of abnormal neurodevelopment.
