Michalak Suzanne M, Mangalesh Shwetha, Shen Liangbo L, McGeehan Brendan, Winter Katrina P, Sarin Neeru, Finkle Joanne, Cotten Michael, Ying Gui-Shuang, Toth Cynthia A, Vajzovic Lejla
Department of Ophthalmology, Duke University School of Medicine, Durham North Carolina.
School of Medicine, Yale University, New Haven, Connecticut.
Ophthalmol Sci. 2021 Jun 7;1(2):100032. doi: 10.1016/j.xops.2021.100032. eCollection 2021 Jun.
To identify systemic health factors associated with a thinner choroid, which has been hypothesized as a cause of poor visual outcomes in low-birth weight infants.
The prospective, observational Study of Eye Imaging in Preterm Infants (BabySTEPS) enrolled infants recommended for retinopathy of prematurity screening based on the American Association of Pediatrics guidelines.
Infants who underwent imaging with investigational handheld OCT at 36 ± 1 weeks' postmenstrual age (PMA) as part of BabySTEPS.
Average choroidal thickness was measured across the central subfoveal 1 mm. We concurrently collected maternal and infant clinical health data. Univariate and multivariate linear regression analyses were performed to evaluate factors associated with choroidal thickness. The left and right eyes showed similar thicknesses, so their average was used for analysis.
Association between infant health factors and subfoveal choroidal thickness.
Subfoveal choroidal thickness was measurable in 82 of 85 infants and 94% of eyes. Mean choroidal thickness was 231 ± 78 μm. In the univariate analysis, a thinner choroid was associated with decreased growth velocity ( < 0.001), lower birth weight ( < 0.001), smaller head circumference ( < 0.001), younger gestational age ( = 0.01), the presence of patent ductus arteriosus ( = 0.05), sepsis or necrotizing enterocolitis ( = 0.03), bronchopulmonary dysplasia ( = 0.03), pulmonary interstitial emphysema ( = 0.002), more days on oxygen support ( < 0.001), and being on oxygen support at 36 weeks ( < 0.001) and at the time of imaging ( < 0.001). In the multivariate analysis, growth velocity ( = 0.002) and oxygen support at the time of OCT imaging ( 0004) remained associated with a thinner choroid.
A thinner choroid is associated independently with growth velocity and receiving oxygen support at 36 ± 1 weeks PMA. This suggests that choroidal development in preterm infants may be related to growth rate in the first weeks of life and the prolonged use of supplemental oxygen. Longitudinal studies are needed to assess differences in choroidal thickness before 36 weeks PMA and to assess their impact on visual outcomes.
确定与脉络膜较薄相关的全身健康因素，脉络膜较薄被认为是低体重婴儿视力预后不良的一个原因。
前瞻性观察性早产儿眼部成像研究（BabySTEPS）纳入了根据美国儿科学会指南推荐进行早产儿视网膜病变筛查的婴儿。
作为BabySTEPS的一部分，在孕龄36±1周时接受了研究性手持式光学相干断层扫描（OCT）成像的婴儿。
测量中央凹下1毫米范围内的平均脉络膜厚度。我们同时收集了母婴临床健康数据。进行单变量和多变量线性回归分析，以评估与脉络膜厚度相关的因素。左眼和右眼厚度相似，因此将其平均值用于分析。
婴儿健康因素与中央凹下脉络膜厚度之间的关联。
85名婴儿中的82名以及94%的眼睛可测量中央凹下脉络膜厚度。平均脉络膜厚度为231±78μm。在单变量分析中，脉络膜较薄与生长速度降低（<0.001）、出生体重较低（<0.001）、头围较小（<0.001）、胎龄较小（=0.01）、动脉导管未闭（=0.05）、败血症或坏死性小肠结肠炎（=0.03）、支气管肺发育不良（=0.03）、肺间质气肿（=0.002）、吸氧天数较多（<0.001）以及在36周时（<0.001）和成像时（<0.001）接受吸氧支持有关。在多变量分析中，生长速度（=0.002）和OCT成像时的吸氧支持（=0.004）仍然与脉络膜较薄有关。
脉络膜较薄与生长速度以及在孕龄36±1周时接受吸氧支持独立相关。这表明早产儿的脉络膜发育可能与生命最初几周的生长速度以及长期使用补充氧气有关。需要进行纵向研究，以评估孕龄36周前脉络膜厚度的差异，并评估其对视力预后的影响。
