From the Department of Ophthalmology (A.F., A.S., F.M.W., E.M.H., N.P., A.K.S.), University Medical Center of the Johannes Gutenberg University Mainz, Mainz, Germany.
From the Department of Ophthalmology (A.F., A.S., F.M.W., E.M.H., N.P., A.K.S.), University Medical Center of the Johannes Gutenberg University Mainz, Mainz, Germany.
Am J Ophthalmol. 2022 Dec;244:88-97. doi: 10.1016/j.ajo.2022.07.019. Epub 2022 Aug 4.
This study investigated whether prematurity and associated factors or prenatal growth restriction have long-term effects on the peripapillary retinal nerve fiber layer (pRNFL) in adulthood.
Retrospective cohort study.
The Gutenberg Prematurity Eye Study (GPES) is a retrospective cohort study with a prospective ophthalmologic examination in Germany. Selected individuals born term and preterm (age 18-52 years) were examined with spectral-domain optical coherence tomography (SD-OCT) in adulthood, and perinatal medical charts were reviewed. The pRNFL thickness was measured using SD-OCT. Univariate and multivariable linear regression analyses were conducted to investigate associations between pRNFL and gestational age (GA; categorical), birth weight percentile (categorical), retinopathy of prematurity (ROP) occurrence, and treatment and other perinatal parameters with adjustment for age, sex, and spherical equivalent.
In total, 766 eyes of 406 preterm and full-term individuals were included (mean age 28.4 ± 8.6 years, 228 females). After adjustment for age, sex, and spherical equivalent, global pRNFL thinning was associated with moderate (GA = 33-36 wk, β = -4.68, P < .001), very (GA = 29-32 wk, β = -5.72, P < .001), and extreme (GA ≤ 28 wk, β = -8.69, P < .001) prematurity but not with low birth weight percentile (<25th percentile, P = .9) and ROP occurrence (P = .9) in multivariable analysis. ROP treatment was associated with increased pRNFL in the temporal sector (P = .002). Maternal smoking during pregnancy showed an association with pRNFL thinning (P = .07).
Our data indicate that the more preterm individuals are born the more pRNFL thinning occurs, whereas prenatal growth restriction and postnatal occurrence of ROP show less effects on pRNFL thickness. Furthermore, individuals with severe ROP with treatment but not lower ROP stages without treatment showed an increased temporal pRNFL thickness.
本研究旨在探讨早产及其相关因素或产前生长受限是否会对成年人的视盘周围视网膜神经纤维层（pRNFL）产生长期影响。
回顾性队列研究。
哥廷根早产儿眼研究（GPES）是一项在德国进行的回顾性队列研究，具有前瞻性眼科检查。选择足月和早产（18-52 岁）的个体在成年期接受频域光学相干断层扫描（SD-OCT）检查，并回顾围产期病历。使用 SD-OCT 测量 pRNFL 厚度。进行单变量和多变量线性回归分析，以调查 pRNFL 与胎龄（GA；分类）、出生体重百分位（分类）、早产儿视网膜病变（ROP）的发生和治疗以及其他围产期参数之间的关联，并进行年龄、性别和等效球镜的调整。
共纳入 406 名足月和早产个体的 766 只眼（平均年龄 28.4 ± 8.6 岁，228 名女性）。在调整年龄、性别和等效球镜后，中度（GA=33-36 周，β=-4.68，P<.001）、重度（GA=29-32 周，β=-5.72，P<.001）和极重度（GA≤28 周，β=-8.69，P<.001）早产与全视网膜变薄有关，但与低出生体重百分位（<25 百分位，P=.9）和 ROP 发生（P=.9）无关在多变量分析中。ROP 治疗与颞区 pRNFL 增厚有关（P=.002）。母亲孕期吸烟与 pRNFL 变薄有关（P=.07）。
我们的数据表明，早产儿出生时胎龄越小，pRNFL 变薄越明显，而产前生长受限和 ROP 发生对 pRNFL 厚度的影响较小。此外，接受严重 ROP 治疗但未接受较低 ROP 阶段治疗的个体显示颞区 pRNFL 厚度增加。
