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Optic disc cupping and prematurity. Large cups as a possible low birth weight sequel
Insights
Children born with low birth weight may have larger optic disc cupping. This ophthalmic finding, observed in ex-premature children, requires further clinical evidence for confirmation.
Area of Science:
- Ophthalmology
- Pediatric Ophthalmology
- Optic Nerve Research
Background:
- Previous ophthalmic studies noted more pronounced optic disc cupping in low birth weight (LBW) ex-premature children compared to full-term controls.
- Cupping was assessed by cup size (cup/disc diameter ratio) and depth (cribriform plate visibility).
Purpose of the Study:
- To extend previous findings on optic disc cupping in ex-premature children.
- To investigate relationships between optic disc cupping and birth weight, sex, visual acuity, and refractive error in a larger cohort.
Main Methods:
- Analysis of data from a cohort of 268 ex-premature children and 187 full-term controls.
- Assessment of optic disc cupping parameters (size and depth).
- Statistical analysis to determine associations with birth weight, sex, visual acuity, and refractive error (including axial eye length).
Main Results:
- Within the ex-premature group, optic disc cup size showed no significant relationship with birth weight, sex, or visual acuity.
- Eyes with myopia of prematurity did not exhibit disproportionately larger cups.
- Across the entire sample, a weak association was found between larger cup size and myopia, and longer axial eye length.
Conclusions:
- Larger optic disc cupping may be a potential sequel of low birth weight, though this requires further substantiation.
- Possible underlying mechanisms include astroglial changes, optic disc distension, and retinal nerve fiber loss.
- The findings suggest a link between early development and later optic nerve head morphology, but statistical significance warrants caution.
Abstract:
In a previous ophthalmic study of ex-prematures around the age of 10 years it was accidentally found that cupping of the optic disc was significantly more pronounced in children of a low birth weight (less than 2000 g) than in full-term controls (Fledelius 1976). This was true for cup size (cup/disc diameter ratio) as well as depth (as indicated by a visible cribriform plate). The present analyses make up an extension of the above study, with additional calculations based on some of its data. Within the ex-prematures (n = 268) the cup size did not seem to be related to birth weight, sex, or visual acuity. Eyes with myopia of prematurity were not especially 'loaded' with large cups. For the whole sample (including the 187 full-term control there was a weak association between cup size and refraction (and axial eye length). Larger cups occurred relatively more often in myopic eyes. Possible mechanisms behind early changes in disc are discussed (astroglial hypothesis--distension of disc--loss of retinal nerve fibers). It is felt that this new observation--large disc cupping as a possible low birth weight sequel--has to be substantiated by further clinical evidence, as statistical type 1 error (mass significance) cannot be ruled out.