Fieß Achim, Janz Johannes, Schuster Alexander K, Kölb-Keerl Ruth, Knuf Markus, Kirchhof Bernd, Muether Philipp S, Bauer Jacqueline
Department of Ophthalmology, Helios Dr. Horst Schmidt Klinik Wiesbaden, Ludwig-Erhard-Straße 100, 65199, Wiesbaden, Germany.
Department of Ophthalmology, University Medical Center Mainz, Mainz, Germany.
Graefes Arch Clin Exp Ophthalmol. 2017 Jul;255(7):1433-1442. doi: 10.1007/s00417-017-3662-5. Epub 2017 Apr 25.
To analyse macular retinal and choroidal layer thickness in former preterm and full-term infants and to assess associated perinatal influence factors and functional correlation.
This prospective controlled, cross-sectional, hospital-based study in a tertiary center of maximum care examined former preterm infants with a gestational age (GA) ≤ 32 weeks and full-term neonates currently aged 4 to 10 years. We investigated data from 397 infants, analysing total foveal retinal thickness and six distinct macular retinal layer and choroidal layer measurements via spectral-domain optical coherence tomography. Multivariable linear regression analysis was performed to investigate associations of layer thickness with GA and retinopathy of prematurity (ROP).
Total retinal thickness in the fovea was thicker in former preterm infants with GA ≤ 28 weeks and in those with GA between 29-32 weeks compared to full-term infants independently of ROP. Occurrence of ROP was also associated with increased foveal thickness. Ganglion cell layer together with inner plexiform layer (GCL+IPL) was thinner in infants with GA ≤ 28 weeks than in full-term infants at 1000 and 2000μm distance from the fovea, but no association with ROP was present. Similar results were found for the photoreceptor layer. Total foveal retinal thickness was associated with low visual function.
This study identified low gestational age and ROP occurrence as main determinants for foveal thickening. Furthermore, thinned GCL+IPL measurements were associated with lower gestational age. This study highlights the prognostic value of these maturity parameters influencing retinal morphology, which may affect visual function.
分析早产和足月出生的既往婴儿黄斑区视网膜和脉络膜层厚度，并评估相关的围产期影响因素及功能相关性。
这项前瞻性对照、横断面、基于医院的研究在一家三级重症监护中心进行，研究对象为胎龄（GA）≤32周的早产既往婴儿和目前年龄在4至10岁的足月新生儿。我们调查了397名婴儿的数据，通过光谱域光学相干断层扫描分析了中央凹视网膜总厚度以及六个不同的黄斑视网膜层和脉络膜层测量值。进行多变量线性回归分析以研究各层厚度与胎龄和早产儿视网膜病变（ROP）的关联。
与足月婴儿相比，GA≤28周的早产既往婴儿以及GA在29 - 32周之间的早产既往婴儿，无论是否患有ROP，其中央凹处的视网膜总厚度均更厚。ROP的发生也与中央凹厚度增加有关。在距离中央凹1000和2000μm处，GA≤28周的婴儿的神经节细胞层和内网状层（GCL + IPL）比足月婴儿薄，但与ROP无关。光感受器层也有类似结果。中央凹视网膜总厚度与低视力功能相关。
本研究确定低胎龄和ROP的发生是中央凹增厚的主要决定因素。此外，GCL + IPL测量值变薄与较低的胎龄有关。本研究强调了这些影响视网膜形态的成熟参数的预后价值，其可能影响视觉功能。
