Glass Torin J A, Chau Vann, Gardiner Jane, Foong Justin, Vinall Jillian, Zwicker Jill G, Grunau Ruth E, Synnes Anne, Poskitt Kenneth J, Miller Steven P
Department of Pediatrics (Neurology), University of Toronto and the Hospital for Sick Children, Toronto, Canada.
Neurosciences & Mental Health, SickKids Research Institute, Toronto, Canada.
Arch Dis Child Fetal Neonatal Ed. 2017 Nov;102(6):F532-F537. doi: 10.1136/archdischild-2016-312533. Epub 2017 May 23.
To determine whether severe retinopathy of prematurity (ROP) is associated with (1) abnormal white matter maturation and (2) neurodevelopmental outcomes at 18 months' corrected age (CA) compared with neonates without severe ROP.
We conducted a prospective longitudinal cohort of extremely preterm neonates born 24-28 weeks' gestational age recruited between 2006 and 2013 with brain MRIs obtained both early in life and at term-equivalent age. Severe ROP was defined as ROP treated with retinal laser photocoagulation. Using diffusion tensor imaging and tract-based spatial statistics (TBSS), white matter maturation was assessed by mean fractional anisotropy (FA) in seven predefined regions of interest. Neurodevelopmental outcomes were assessed with Bayley Scales of Infant and Toddler Development-III (Bayley-III) composite scores at 18 months' CA. Subjects were compared using Fisher's exact, Kruskal-Wallis and generalised estimating equations.
Families were recruited from the neonatal intensive care unit at BC Women's Hospital.
Of 98 extremely preterm neonates (median: 26.0 weeks) assessed locally for ROP, 19 (19%) had severe ROP and 83 (85%) were assessed at 18 months' CA.
Severe ROP was associated with lower FA in the posterior white matter, and with decreased measures of brain maturation in the optic radiations, posterior limb of the internal capsule (PLIC) and external capsule on TBSS. Bayley-III cognitive and motor scores were lower in infants with severe ROP.
Severe ROP is associated with maturational delay in the optic radiations, PLIC, external capsule and posterior white matter, housing the primary visual and motor pathways, and is associated with poorer cognitive and motor outcomes at 18 months' CA.
确定与无重度早产儿视网膜病变（ROP）的新生儿相比，重度ROP是否与（1）白质成熟异常以及（2）矫正年龄（CA）18个月时的神经发育结局相关。
我们对2006年至2013年间出生的孕周为24 - 28周的极早产儿进行了一项前瞻性纵向队列研究，在其生命早期和足月等效年龄时均进行了脑部MRI检查。重度ROP定义为接受视网膜激光光凝治疗的ROP。使用扩散张量成像和基于纤维束的空间统计学（TBSS），通过七个预定义感兴趣区域的平均各向异性分数（FA）评估白质成熟情况。在矫正年龄18个月时，使用贝利婴幼儿发展量表第三版（Bayley - III）综合评分评估神经发育结局。使用Fisher精确检验、Kruskal - Wallis检验和广义估计方程对受试者进行比较。
研究对象从卑诗省妇女医院新生儿重症监护病房招募。
在当地接受ROP评估的98例极早产儿（中位孕周：26.0周）中，19例（19%）患有重度ROP，83例（85%）在矫正年龄18个月时接受了评估。
重度ROP与后白质中较低的FA相关，并且在TBSS上，视辐射、内囊后肢（PLIC）和外囊的脑成熟度测量值降低。重度ROP婴儿的Bayley - III认知和运动评分较低。
重度ROP与视辐射、PLIC、外囊和后白质的成熟延迟相关，这些区域包含主要的视觉和运动通路，并且与矫正年龄18个月时较差的认知和运动结局相关。
