Samarawickrama Chameen, Huynh Son C, Liew Gerald, Burlutsky George, Mitchell Paul
Centre for Vision Research, Department of Ophthalmology and Westmead Millennium Institute, University of Sydney, New South Wales, Australia.
Ophthalmology. 2009 Jun;116(6):1112-8. doi: 10.1016/j.ophtha.2008.12.061. Epub 2009 Apr 22.
To assess the relationship of birth weight, birth length, and head circumference as proxy markers of intrauterine growth, cup/disc ratio, and other optic disc parameters measured using optical coherence tomography (OCT).
Population-based cross sectional analysis.
The Sydney Childhood Eye Study examined 2353 primarily 12-year-old children from 21 randomly selected secondary schools during 2003 to 2005.
Of 2353 children examined, 2134 (90.7%) had OCT scans (Zeiss Stratus OCT, Carl Zeiss Meditec, Dublin, CA) and are included in this study. The "fast" optic disc scan protocol was used. Birth weight, birth length, and head circumference were ascertained from health records. Height and weight were measured using standardized protocols, body mass index (BMI) was defined as weight (kilograms)/ height squared (meters), and sociodemographic information was collected in a questionnaire completed by parents. Low birth weight was defined as birth weight <or=2499 g, and prematurity was defined as gestation less than 37 weeks. Logistic and mixed model analyses were performed.
Vertical optic disc and optic cup diameters, and cup/disc ratio.
Children of low birth weight had decreased vertical disc diameter, increased cup diameter, and increased cup/disc ratio by 30 microm (P = 0.009), 44 microm (P = 0.004), and 0.03 (P<0.0001), respectively. After adjusting for age, gender, ethnicity, height, axial length, and BMI, birth weight remained positively associated with vertical optic disc diameter and inversely associated with both vertical optic cup diameter and vertical cup/disc ratio (each kilogram increase was associated with a 0.0133-mm larger mean disc diameter; P = 0.04; a 0.0203-mm smaller mean cup diameter; P = 0.02; and a 0.0136 reduction in mean cup/disc ratio; P = 0.002). These associations were not present in children with gestational age less than 33 weeks. Smaller birth length and head circumference were similarly associated with larger cup/disc ratio.
Low birth weight, short birth length, and small head circumference at birth were associated with larger cup/disc ratio in children aged 12 years. Our findings suggest that fetal growth restriction could adversely influence optic nerve head parameters. This may have implications for future risk of glaucomatous optic neuropathy.
FINANCIAL DISCLOSURE(S): The author(s) have no proprietary or commercial interest in any materials discussed in this article.
评估出生体重、出生身长和头围作为宫内生长的替代指标、杯盘比以及使用光学相干断层扫描（OCT）测量的其他视盘参数之间的关系。
基于人群的横断面分析。
悉尼儿童眼病研究在2003年至2005年期间对来自21所随机选择的中学的2353名主要为12岁的儿童进行了检查。
在接受检查的2353名儿童中，2134名（90.7%）进行了OCT扫描（蔡司Stratus OCT，卡尔蔡司医疗技术公司，加利福尼亚州都柏林）并纳入本研究。使用了“快速”视盘扫描方案。从健康记录中确定出生体重、出生身长和头围。使用标准化方案测量身高和体重，体重指数（BMI）定义为体重（千克）/身高的平方（米），并通过父母填写的问卷收集社会人口统计学信息。低出生体重定义为出生体重≤2499克，早产定义为孕周小于37周。进行了逻辑回归和混合模型分析。
垂直视盘和视杯直径以及杯盘比。
低出生体重儿童的垂直视盘直径减小、杯直径增大、杯盘比增加，分别增加30微米（P = 0.009）、44微米（P = 0.004）和0.03（P<0.0001）。在调整年龄、性别、种族、身高、眼轴长度和BMI后，出生体重与垂直视盘直径仍呈正相关，与垂直视杯直径和垂直杯盘比呈负相关（每增加1千克，平均视盘直径增大0.0133毫米；P = 0.04；平均杯直径减小0.0203毫米；P = 0.02；平均杯盘比降低0.0136；P = 0.002）。这些关联在孕周小于33周的儿童中不存在。较小的出生身长和头围与较大的杯盘比同样相关。
出生时低出生体重、短小的出生身长和小头围与12岁儿童较大的杯盘比相关。我们的研究结果表明，胎儿生长受限可能对视神经乳头参数产生不利影响。这可能对未来青光眼性视神经病变的风险有影响。
作者对本文中讨论的任何材料均无所有权或商业利益。
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