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Risk Factors and Structural Impact of Macular Edema in Preterm Infants: An OCT-Based Cohort Study

Weiming Yang1, Xiaohong Zhou1, Yian Li1

  • 1Department of Ophthalmology, Children's Hospital of Fudan University, National Children's Medical Center, Shanghai, China.

Investigative Ophthalmology & Visual Science
|May 6, 2026
PubMed

Insights

Macular edema (ME) in preterm infants can cause lasting foveal abnormalities, even after apparent resolution. Postnatal factors like respiratory support and nutrition, not birth details, are key risk factors for ME development.

Area of Science:

  • Ophthalmology
  • Neonatology
  • Medical Imaging

Background:

  • Macular edema (ME) is a significant concern in preterm infants, potentially impacting visual development.
  • Optical coherence tomography (OCT) is crucial for diagnosing and monitoring retinal conditions in neonates.
  • Understanding risk factors for ME is vital for timely intervention and improved outcomes.

Purpose of the Study:

  • To identify risk factors associated with macular edema (ME) in preterm infants.
  • To assess the impact of ME on the structural development of the fovea in this population.
  • To utilize handheld optical coherence tomography (OCT) and clinical data for comprehensive investigation.

Main Methods:

  • A retrospective cohort study of 106 preterm infants screened for retinopathy of prematurity using RetCam 3 and OCT.
  • Clinical data were collected, and ME was classified based on OCT morphology.
  • Quantitative foveal parameters were measured, and logistic regression models identified ME risk factors.

Main Results:

  • 25.5% of infants developed ME. Infants with resolved ME exhibited persistent foveal abnormalities, including increased central foveal thickness (CFT) and foveal outer retinal thickness (FORT).
  • Independent risk factors for ME included higher postmenstrual age at OCT, prolonged phototherapy, respiratory support, and high nutritional risk.
  • Birth weight, gestational age, and Apgar scores were not significant predictors of ME.

Conclusions:

  • Macular edema in preterm infants is linked to persistent foveal structural changes, even after apparent resolution on OCT.
  • Postnatal factors such as nutrition, respiratory support, and phototherapy are more strongly associated with ME development than perinatal factors.
  • Risk-based OCT monitoring and extended follow-up are recommended for preterm infants at risk for ME.
Abstract

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