Fieß Achim, Wagner Felix M, Urschitz Michael S, Nagler Markus, Stoffelns Bernhard, Wild Philipp S, Münzel Thomas, Beutel Manfred E, Lackner Karl J, Pfeiffer Norbert, Schuster Alexander K
Department of Ophthalmology, University Medical Center of the Johannes Gutenberg University Mainz, Mainz, Germany.
Division of Pediatric Epidemiology, Institute for Medical Biostatistics, Epidemiology and Informatics, University Medical Center of the Johannes Gutenberg University Mainz, Mainz, Germany.
Invest Ophthalmol Vis Sci. 2021 Nov 1;62(14):9. doi: 10.1167/iovs.62.14.9.
Low birth weight (BW) is associated with alterations of foveal shape development in childhood-leading to an increased retinal thickness of the fovea. The aim of the present study was to assess whether BW has a long-term effect on foveal retinal thickness (RT) and is still present in adulthood.
In the German population-based Gutenberg Health Study (GHS), participants were examined with spectral-domain optical coherence tomography. The association between self-reported BW and RT in the foveolar and perifoveal locations was assessed. Multivariable linear regression analyses with adjustment for potential confounders and grading of foveal hypoplasia were performed.
Overall, RT measurements and self-reported BW were available for 2,539 participants (1300 female, mean age 54.5 ± 9.7 years). The absolute foveolar RT was 239.6 ± 25.8 µm, 232.2 ± 20.1 µm and 234.8 ± 21.0 µm, respectively, in the low (<2500 g), normal (2500-4000 g) and high (>4000 g) BW groups (P < 0.001). After adjustment for confounders, an association was observed between lower BW and increased foveolar thickness (B = -0.35 [95% confidence interval {CI}: -0.49; -0.20] µm/100 g; P < 0.001), whereas only a weak association with RT was observed with the nasal (P = 0.010), temporal (P = 0.011), and inferior (P = 0.021) quadrants in the 1 mm distance, with no association in the 2 mm distance to the fovea. Foveal hypoplasia grade 1 was more frequent in the low BW group (6.8%) compared to the normal (0.9%) and high BW group (1.2%).
This study provides evidence of an association between lower BW and increased foveolar thickness and foveal hypoplasia, indicating that prenatal growth may affect macular morphology, which in turn may persist until adulthood and predispose to retinal disease later in life.
低出生体重与儿童期黄斑形状发育改变相关，可导致黄斑视网膜厚度增加。本研究旨在评估出生体重是否对黄斑视网膜厚度（RT）有长期影响，以及这种影响在成年期是否依然存在。
在基于德国人群的古登堡健康研究（GHS）中，参与者接受了光谱域光学相干断层扫描检查。评估了自我报告的出生体重与黄斑中心凹及黄斑周围区域RT之间的关联。进行了多变量线性回归分析，并对潜在混杂因素进行了调整，同时对黄斑发育不全进行了分级。
总体而言，2539名参与者（1300名女性，平均年龄54.5±9.7岁）有RT测量值和自我报告的出生体重数据。低出生体重（<2500g）、正常出生体重（2500 - 4000g）和高出生体重（>4000g）组的黄斑中心凹绝对RT分别为239.6±25.8μm、232.2±20.1μm和234.8±21.0μm（P<0.001）。在对混杂因素进行调整后，观察到较低的出生体重与黄斑中心凹厚度增加之间存在关联（B = -0.35 [95%置信区间{CI}：-0.49；-0.20]μm/100g；P<0.001），而在距离黄斑1mm处的鼻侧（P = 0.010）、颞侧（P = 0.011）和下方（P = 0.021）象限仅观察到与RT的微弱关联，在距离黄斑2mm处无关联。与正常出生体重组（0.9%）和高出生体重组（1.2%）相比，低出生体重组中1级黄斑发育不全更为常见（6.8%）。
本研究提供了证据，表明较低的出生体重与黄斑中心凹厚度增加及黄斑发育不全之间存在关联，这表明产前生长可能影响黄斑形态，而这种影响可能持续到成年期，并使个体在生命后期易患视网膜疾病。
