Department of Ophthalmology, Philipps-University, Universitätsklinikum Giessen and Marburg GmbH, Marburg Campus, Marburg, Germany.
Department of Ophthalmology, Goethe-University, Theodor-Stern-Kai 7, 60590, Frankfurt Am Main, Germany.
Graefes Arch Clin Exp Ophthalmol. 2023 Sep;261(9):2701-2707. doi: 10.1007/s00417-023-06069-2. Epub 2023 Apr 29.
This study aims to evaluate the impact of birth weight (BW), gestational age (GA), retinopathy of prematurity (ROP), and perinatal brain injury (PBI) on optic nerve head (ONH) parameters and nerve fiber layer thickness (RNFLT) in preterm children.
ONH parameters and RNFLT were examined prospectively in 5-15-year-old preterm and full-term children with RTVue-100 OCT (Optovue, USA). The parameters of the two groups were compared and possible influences of BW, GA, ROP, and PBI analyzed in preterm children.
In total, 51 full-term and 55 preterm children were included. The mean age was 9.98 ± 3.4 years in full-term and 10.0 ± 2.5 years in preterm children. The mean GA in preterm children was 29.6 ± 3.8 weeks with a BW of 1523 ± 732 g. RNFLT was significantly lower in preterm than in full-term children in all but temporal quadrants. Cup area, volume, cup/disc area ratio, and horizontal cup/disc ratio (CDR) were significantly larger and rim area significantly thinner in preterm children. GA was positively correlated with superior, nasal, and overall RNFLT and negatively correlated with cup area, volume, and horizontal CDR. ROP stage correlated negatively with superior and nasal RNFLT. PBI was the only significant predicting factor for RNFL thinning in all but temporal quadrant in multiple regression analysis. Preterm children with PBI had a significantly larger optic cup (CDR 0.70 ± 0.33 vs. 0.37 ± 0.27) and thinner optic rim.
PBI correlated strongest with RNFL thinning, a thinner optic rim, and a larger optic cup in preterm children and should be evaluated in each patient to prevent incorrect diagnosis like glaucoma.
本研究旨在评估出生体重（BW）、胎龄（GA）、早产儿视网膜病变（ROP）和围产期脑损伤（PBI）对早产儿视神经头（ONH）参数和神经纤维层厚度（RNFLT）的影响。
使用 RTVue-100 OCT（Optovue，美国）对 5-15 岁的早产儿和足月儿的 ONH 参数和 RNFLT 进行前瞻性检查。比较两组的参数，并分析早产儿 BW、GA、ROP 和 PBI 的可能影响。
共纳入 51 名足月儿和 55 名早产儿。足月儿的平均年龄为 9.98±3.4 岁，早产儿为 10.0±2.5 岁。早产儿的平均 GA 为 29.6±3.8 周，BW 为 1523±732g。除颞象限外，早产儿的 RNFLT 明显低于足月儿。杯面积、容积、杯/盘面积比和水平杯/盘比（CDR）明显增大，而视盘周围视网膜神经纤维层（RNFL）厚度明显变薄。GA 与上、鼻、总 RNFLT 呈正相关，与杯面积、容积和水平 CDR 呈负相关。ROP 分期与上、鼻 RNFLT 呈负相关。在多元回归分析中，PBI 是除颞象限外所有象限 RNFL 变薄的唯一显著预测因素。PBI 的早产儿视杯（CDR 0.70±0.33 比 0.37±0.27）更大，视盘周围视网膜神经纤维层更薄。
PBI 与早产儿的 RNFL 变薄、视盘周围视网膜神经纤维层更薄和视杯更大相关性最强，应在每位患者中进行评估，以防止漏诊像青光眼这样的疾病。
