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极早产出生的11岁儿童的视乳头周围视网膜神经纤维层厚度和黄斑神经节细胞层体积与运动和认知结果的关系

Peripapillary retinal nerve fibre layer thickness and macular ganglion cell layer volume in association with motor and cognitive outcomes in 11-year-old children born very preterm.

作者信息

Lehtonen Tuomo, Vesti Eija, Haataja Leena, Nyman Anna, Uusitalo Karoliina, Leinonen Markku T, Setänen Sirkku

机构信息

Department of Ophthalmology, University of Turku, Turku, Finland.

Turku University Hospital, Turku, Finland.

出版信息

Acta Ophthalmol. 2023 May;101(3):342-348. doi: 10.1111/aos.15266. Epub 2022 Oct 18.

DOI:10.1111/aos.15266
PMID:36259094
Abstract

PURPOSE

The purpose of the study was to study the association between retinal parameters and motor and cognitive outcomes in children born very preterm.

METHODS

This study is part of a prospective cohort study of very preterm infants (birth weight ≤ 1500 grams/gestational age < 32 weeks). At 11 years of age, the ophthalmological assessment included a retinal optical coherence tomography (OCT) examination of the peripapillary retinal nerve fibre layer (PRNFL) and the macular ganglion cell layer (GCL). The motor performance was assessed with the Movement Assessment Battery for Children-Second Edition (Movement ABC-2), and the cognitive outcome with the Wechsler Intelligence Scale for Children-Fourth Edition (WISC-IV).

RESULTS

A total of 141 children were included. The mean (SD) average PRNFL was 95 μm (10.2 μm). The mean (SD) macular GCL volume was 0.34 mm (0.03 mm ). Higher PRNFL thickness associated with higher percentiles for total scores in the motor assessment (b = 0.5, 95% CI 0.1-0.8, p = 0.01) and higher macular GCL volume with higher scores in the cognitive assessment (b = 1.4, 95% CI 0.5-2.3, p = 0.002), also when adjusted for gender, birth weight z-score (birth weight in relation to gestational age) and major brain pathology at term.

CONCLUSION

The associations between higher average PRNFL thickness and better motor performance as well as higher macular GCL volume and better cognitive performance refer to more generalized changes in the brain of 11-year-old children born very preterm. Retinal OCT examinations might provide a deeper insight than mere eyesight in long-term neurodevelopmental follow-up of children born very preterm.

摘要

目的

本研究旨在探讨极早产儿视网膜参数与运动及认知结局之间的关联。

方法

本研究是一项对极早产儿(出生体重≤1500克/胎龄<32周)进行的前瞻性队列研究的一部分。在11岁时,眼科评估包括对视乳头周围视网膜神经纤维层(PRNFL)和黄斑神经节细胞层(GCL)进行视网膜光学相干断层扫描(OCT)检查。运动表现采用儿童运动评估量表第二版(Movement ABC-2)进行评估,认知结局采用韦氏儿童智力量表第四版(WISC-IV)进行评估。

结果

共纳入141名儿童。PRNFL平均(标准差)厚度为95μm(10.2μm)。黄斑GCL平均(标准差)体积为0.34mm³(0.03mm³)。PRNFL厚度越高,运动评估总分的百分位数越高(b = 0.5,95%可信区间0.1 - 0.8,p = 0.01);黄斑GCL体积越大,认知评估得分越高(b = 1.4,95%可信区间0.5 - 2.3,p = 0.002),在对性别、出生体重z评分(出生体重与胎龄的关系)和足月时的主要脑病变进行校正后也是如此。

结论

较高的PRNFL平均厚度与较好的运动表现以及较高的黄斑GCL体积与较好的认知表现之间的关联,表明极早产的11岁儿童大脑存在更广泛的变化。视网膜OCT检查可能比单纯的视力检查更能深入了解极早产儿的长期神经发育随访情况。

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