Pueyo Victoria, Pérez Teresa, González Inmaculada, Altemir Irene, Gimenez Galadriel, Prieto Esther, Paules Cristina, Oros Daniel, Lopez-Pison Javier, Fayed Nicolás, Garcia-Martí Gracián, Sanz-Requena Roberto, Marin Miguel Angel
Aragon Institute for Health Research (IIS Aragón), Ophthalmology Department, Miguel Servet University Hospital, Zaragoza, Spain.
Aragon Institute for Health Research (IIS Aragón), Obstetrics Department, Hospital Clínico Universitario Zaragoza, Zaragoza, Spain.
Br J Ophthalmol. 2017 Sep;101(9):1168-1173. doi: 10.1136/bjophthalmol-2016-309790. Epub 2017 Feb 9.
To identify differences in neuronal tissue from retinal and brain structures in children born small for gestational age (SGA) with no abnormality in neonatal brain ultrasonography and no previous neurological impairment, and to evaluate the relationship between retinal structure and brain changes in school-age children born SGA.
Two cohorts of children were recruited: 25 children born SGA and 25 children born with an appropriate birth weight according to gestational age. All the children underwent an ophthalmic examination, which included retinal imaging using spectral-domain optical coherence tomography, and a brain MRI. MRI images were automatically segmented and global and regional brain volumes were obtained.
Although visual function did not differ between both groups, the complex ganglion cell and inner plexiform layers (GCL-IPL) was thinner in SGA children. Total intracranial volume, and global grey and white matter volumes in brain and cerebellum were correlated with birthweight centile, as were certain regional volumes (temporal and parietal lobes, hippocampus and putamen). Abnormal GCL-IPL measurements accurately identified SGA children with the most severe grey and white matter changes in the brain.
SGA children, both preterm and term born, showed evidence of structural abnormalities in the retina, which may be an accurate and non-invasive biomarker of neuronal damage in brain tissue.
识别胎龄小的低出生体重(SGA)儿童视网膜和脑结构中神经元组织的差异,这些儿童新生儿脑超声检查无异常且既往无神经功能损害,并评估学龄期SGA出生儿童视网膜结构与脑变化之间的关系。
招募了两组儿童:25名SGA出生的儿童和25名根据胎龄出生体重正常的儿童。所有儿童均接受眼科检查,包括使用光谱域光学相干断层扫描进行视网膜成像,以及脑部MRI检查。MRI图像自动分割并获得全脑和局部脑体积。
尽管两组儿童的视觉功能无差异,但SGA儿童的复杂神经节细胞和内网状层(GCL-IPL)较薄。颅内总体积、脑和小脑的全脑灰质和白质体积与出生体重百分位数相关,某些局部体积(颞叶和顶叶、海马体和壳核)也与出生体重百分位数相关。GCL-IPL测量异常准确地识别出脑部灰质和白质变化最严重的SGA儿童。
早产和足月出生的SGA儿童均显示视网膜存在结构异常证据,这可能是脑组织神经元损伤的一种准确且非侵入性的生物标志物。