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Very Preterm Infant Retinal Microanatomy at 36 Weeks' Postmenstrual Age and 2-Year Neurodevelopment.

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Optical coherence tomography (OCT) retinal imaging in very preterm (VPT) infants can predict neurodevelopmental outcomes. Thicker retinal nerve fiber layer (RNFL) thickness at 36 weeks

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Area of Science:

  • Neuroscience
  • Ophthalmology
  • Neonatology

Background:

  • Noninvasive optical coherence tomography (OCT) retinal imaging may predict neurodevelopmental outcomes in very preterm (VPT) infants.
  • VPT infants (<32 weeks' gestational age) are at high risk for neurodevelopmental impairments.

Purpose of the Study:

  • To evaluate if retinal microanatomy findings on OCT in VPT infants at 36 weeks' postmenstrual age (PMA) correlate with 2-year neurodevelopmental outcomes.

Main Methods:

  • A prospective, longitudinal cohort study (BabySTEPS) followed VPT infants from birth through age 2 years.
  • OCT imaging of the retina was performed at 36 weeks' PMA.
  • Neurodevelopmental outcomes were assessed using the Bayley Scales of Infant and Toddler Development (BSID-III), Child Behavior Checklist, and M-CHAT-R, with adjustments for gestational age, small for gestational age status, maternal education, and PMA at imaging.

Main Results:

  • Greater retinal nerve fiber layer (RNFL) thickness was associated with better motor and cognitive scores (BSID-III) and lower autism risk (M-CHAT-R) and internalizing problems (Child Behavior Checklist) at 2 years.
  • Increased choroidal thickness was linked to higher motor scores.
  • RNFL thickness significantly improved the prediction of motor and cognitive outcomes when added to infant factors.

Conclusions:

  • Retinal nerve fiber layer (RNFL) thickness measured by OCT at 36 weeks' PMA is a significant predictor of motor and cognitive neurodevelopmental outcomes at 2 years in very preterm infants.
  • These findings suggest OCT could be a valuable tool for guiding the management of VPT infants.