Preterm Optic Disc Morphology on Handheld OCT and 5-Year Visual Outcomes

Area of Science:

• Ophthalmology
• Neonatal Medicine
• Medical Imaging

Background:

• Premature infants are at increased risk for visual impairments.
• Early detection and prediction of visual outcomes are crucial for timely intervention.
• Optic disc morphology may offer insights into long-term visual development.

Purpose of the Study:

• To investigate if neonatal optic disc morphology, measured by handheld spectral-domain optical coherence tomography (SD-OCT), predicts visual acuity (VA) and refractive outcomes in premature infants.
• To explore potential biomarkers for refractive development in preterm infants.

Main Methods:

• Retrospective analysis of an observational study involving premature infants.
• Handheld SD-OCT imaging at ~36 weeks' postmenstrual age (PMA) to quantify optic disc parameters (diameter, cup depth, cup-to-disc ratio [CDR]).
• Assessment of visual acuity and cycloplegic refraction at 9 months, 2 years, and 5 years.

Main Results:

• Optic disc metrics (diameter, cup depth, CDR) at 36 weeks' PMA were not associated with visual acuity or spherical equivalent (SE) at 9 months or 2 years.
• Neonatal optic disc morphology did not predict visual acuity at 5 years.
• Greater neonatal cup depth and higher CDR were significantly associated with increased hyperopia at 5 years.

Conclusions:

• Neonatal optic disc morphology, while not predictive of visual acuity, is associated with refractive development in premature infants.
• Deeper optic cups and larger CDRs in neonates may indicate a predisposition to developing hyperopia later in childhood.
• These findings suggest optic disc parameters as potential novel biomarkers for refractive development in the preterm population.