Related Experiment Video
Updated: Jun 23, 2026
Ex Vivo OCT-Based Multimodal Imaging of Human Donor Eyes for Research into Age-Related Macular Degeneration
Published on: May 26, 2023
Preterm Optic Disc Morphology on Handheld OCT and 5-Year Visual Outcomes
Rodrigo Guillen1, Zahraa Omar Alomar1, Hyeshin Jeon2,3
1University of Washington School of Medicine, Seattle, Washington.
Purpose:
To determine whether neonatal optic disc morphology measured with handheld spectral-domain OCT (SD-OCT) predicts long-term visual acuity (VA) and refractive outcomes in premature infants.
Design:
Secondary retrospective analysis of an observational study.
Subjects:
Premature infants undergoing routine retinopathy of prematurity screening at a tertiary neonatal intensive care unit.
Methods:
Handheld SD-OCT was performed at approximately 36 weeks' postmenstrual age (PMA). A semiautomated algorithm quantified optic disc diameter, cup depth, and cup-to-disc ratio (CDR). Visual acuity and cycloplegic refraction were assessed at 9 months, 2 years, and 5 years.
Main Outcome Measures:
Visual acuity and spherical equivalent (SE) at 9 months, 2 years, and 5 years.
Results:
The study included 132 eyes from 66 premature infants. The mean disc diameter at 36 weeks' PMA was 1829 ± 270 μm, cup depth 517 ± 382 μm, and CDR 0.50 ± 0.24. The mean logarithm of the minimum angle of resolution VA was 0.69 ± 0.18 at 9 months, 0.65 ± 0.17 at 2 years, and 0.10 ± 0.15 at 5 years. The mean SE was 1.68 ± 1.54 diopters (D), 0.82 ± 1.87 D, and 0.58 ± 1.30 D, respectively. Optic disc metrics were not associated with VA or SEs at 9 months (n = 52 eyes) or 2 years (n = 39; P > 0.18). They did not predict VA at 5 years (n = 23; P > 0.37). At 5 years, however, greater neonatal cup depth and higher CDR were significantly associated with increased hyperopia (n = 27; P = 0.006 and P = 0.02, respectively), while disc diameter was not. Neonatal sepsis and intraventricular hemorrhage independently predicted poorer VA at 5 years (P = 0.04 and P = 0.001, respectively).
Conclusions:
Acknowledging a high lost to follow-up rate, neonatal optic disc morphology was not predictive of VA outcomes but was associated with refractive development, with deeper cups and larger CDRs linked to greater hyperopia at 5 years. These findings suggest novel biomarkers for refractive development in the preterm population that deserve further exploration.
Financial Disclosures:
Proprietary or commercial disclosure may be found in the Footnotes and Disclosures at the end of this article.
