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围产期相关因素与光学相干断层扫描血管造影显示的前早产儿中心视网膜改变的关系。

Perinatal risk factors associated with central retinal changes in former preterm children on optical coherence tomography angiography.

机构信息

Eye Hospital, University Medical Centre Ljubljana, Ljubljana, Slovenia.

Faculty of Medicine, University of Ljubljana, Ljubljana, Slovenia.

出版信息

Acta Ophthalmol. 2022 Feb;100(1):e122-e127. doi: 10.1111/aos.14870. Epub 2021 Apr 8.

DOI:10.1111/aos.14870
PMID:33829666
Abstract

PURPOSE

To assess the association between perinatal risk factors for retinopathy of prematurity (ROP) and central retinal structures of former preterm children seen on optical coherence tomography angiography (OCTA).

METHODS

This prospective cohort study included 40 children with a history of preterm birth and 33 healthy full-term children. We documented their birth weight, gestational age, other significant risk factors for ROP development and presence of ROP. Imaging was performed using swept-source OCTA, and quantitative evaluation was performed. Analytic parameters included the area of foveal avascular zone (FAZ), foveal depth (FD), central subfoveal retinal thickness (CSFT) and capillary density index (CDI) of the deep and superficial capillary plexus.

RESULTS

Preterm children had significantly smaller FAZ, lower FD and higher CSFT compared to controls (all p < 0.001). Both groups exhibited no differences in total CDI at the superficial (p = 0.969) and deep capillary plexus (p = 0.370). The duration of mechanical ventilation correlated negatively with FAZ and FD but positively with CSFT. The duration of supplemental oxygen treatment correlated negatively with FD. The presence of intraventricular haemorrhage correlated negatively with FAZ and FD but positively with CSFT. Regression analysis found that the duration of mechanical ventilation and the presence of bronchopulmonary dysplasia were associated with lower FD (p = 0.002 and 0.01, respectively) and higher CSFT (p = 0.002 and 0.028, respectively).

CONCLUSION

Central retinal anomalies were identified in former preterm children using OCTA. Macular changes were associated with several risk factors for ROP development.

摘要

目的

评估早产儿视网膜病变(ROP)围产期危险因素与光学相干断层扫描血管造影(OCTA)所见前早产儿中心视网膜结构之间的关系。

方法

本前瞻性队列研究纳入 40 名有早产儿病史的儿童和 33 名健康足月儿童。我们记录了他们的出生体重、胎龄、ROP 发生的其他重要危险因素和 ROP 的存在情况。使用扫频源 OCTA 进行成像,并进行定量评估。分析参数包括无血管区(FAZ)面积、中心凹深度(FD)、中心下视网膜厚度(CSFT)和深层及浅层毛细血管丛的毛细血管密度指数(CDI)。

结果

与对照组相比,早产儿的 FAZ 更小、FD 更低、CSFT 更高(均 p<0.001)。两组浅层(p=0.969)和深层毛细血管丛(p=0.370)的总 CDI 无差异。机械通气时间与 FAZ 和 FD 呈负相关,与 CSFT 呈正相关。补充氧气治疗时间与 FD 呈负相关。脑室出血的存在与 FAZ 和 FD 呈负相关,与 CSFT 呈正相关。回归分析发现,机械通气时间和支气管肺发育不良的存在与 FD 降低(p=0.002 和 0.01)和 CSFT 升高(p=0.002 和 0.028)有关。

结论

OCTA 在前早产儿中发现了中心视网膜异常。黄斑改变与 ROP 发生的几个危险因素有关。

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