Michalak Suzanne M, Mangalesh Shwetha, Chen Yineng, Shen Liangbo L, Tai Vincent, Winter Katrina, Sarin Neeru, Ying Gui-Shuang, Toth Cynthia A, Vajzovic Lejla
Department of Ophthalmology, Duke University School of Medicine, Durham, North Carolina.
Department of Ophthalmology, Stanford University, Palo Alto, California.
Ophthalmol Sci. 2023 Jul 4;4(1):100359. doi: 10.1016/j.xops.2023.100359. eCollection 2024 Jan-Feb.
To characterize changes in subfoveal choroidal thickness in preterm infants from 30 to 60 weeks' postmenstrual age (PMA).
The prospective, observational Study of Eye Imaging in Preterm infantS (BabySTEPS) enrolled infants eligible for retinopathy of prematurity screening per the American Association of Pediatrics guidelines.
Infants imaged with an investigational, handheld OCT at ≥ 4 distinct imaging sessions between 30 to 60 weeks' PMA as part of BabySTEPS.
Average choroidal thickness across the central subfoveal 1 mm in each eye at each time point was measured using custom segmentation software, and errors were manually corrected by a trained grader. We prospectively collected birth history data. A segmented mixed model was used to analyze the change in choroidal thickness as a function of PMA, birth weight, and gestational age (GA).
Characterization of normative subfoveal choroidal thickness values and choroidal growth rate between 30 to 60 weeks' PMA.
We included 592 imaging sessions of 79 preterm infants (152 eyes). Mean (± standard deviation) GA was 27.5 ± 2.5 weeks. Mean choroidal thickness was 141.4 ± 34.5 μm at 30 weeks, 272.2 ± 83.9 μm at 38 weeks, and 306.2 ± 77.4 μm between 56 and 60 weeks. Between 30 and 60 weeks' PMA, choroidal growth followed a biphasic model, with a linear growth rate of 14.8 μm per week (95% confidence interval [CI], 13.6-16.0) from 30 until 38.4 weeks, then cessation of growth, with a growth rate of 0.3 μm per week (95% CI, -1.1 to 1.6) from 38.4 to 60 weeks. Infants with extremely low birth weight (ELBW; < 1000 g) and extremely preterm (GA < 28 weeks) infants had significantly slower initial growth rates compared with very low and low birth weight and very preterm and preterm infants (ELBW 13.0 vs. 21.0 μm per week; < 0.0001 and extremely preterm 13.2 vs. 18.0 μm per week; = 0.003).
Preterm infant choroidal thickness experiences rapid linear growth from 30 to 38 weeks' PMA, at which time growth nearly stops. These foundational measurements and identification of the impact of extremes of low birth weight and prematurity on choroidal development will be essential as researchers begin to understand the role of choroidal development in ocular and retinal health in human infants.
Proprietary or commercial disclosure may be found in the Footnotes and Disclosures at the end of this article.
描述孕龄30至60周的早产儿中心凹下脉络膜厚度的变化。
前瞻性观察性早产儿眼部成像研究（BabySTEPS）纳入了符合美国儿科学会指南中早产儿视网膜病变筛查标准的婴儿。
作为BabySTEPS的一部分，在孕龄30至60周期间，≥4次不同成像检查时，使用研究性手持光学相干断层扫描（OCT）对婴儿进行成像。
使用定制分割软件测量每个时间点每只眼睛中央1mm中心凹下的平均脉络膜厚度，测量误差由经过培训的分级人员手动校正。我们前瞻性收集了出生史数据。使用分段混合模型分析脉络膜厚度随孕龄、出生体重和胎龄（GA）的变化。
孕龄30至60周期间中心凹下脉络膜厚度的正常数值及脉络膜生长速率的特征。
我们纳入了79名早产儿（152只眼）的592次成像检查。平均（±标准差）胎龄为27.5±2.5周。30周时平均脉络膜厚度为141.4±34.5μm，38周时为272.2±83.9μm，56至60周时为306.2±77.4μm。在孕龄30至60周期间，脉络膜生长呈双相模型，从30周直至38.4周，线性生长速率为每周14.8μm（95%置信区间[CI]，13.6 - 16.0），然后生长停止，从38.4周至60周生长速率为每周0.3μm（95%CI，-1.1至1.6）。极低出生体重（ELBW；<1000g）婴儿和极早产儿（胎龄<28周）与超低和低出生体重以及极早产和早产儿相比，初始生长速率明显较慢（ELBW为每周13.0μm 对21.0μm；<0.0001，极早产儿为每周13.2μm 对18.0μm；=0.003）。
早产儿脉络膜厚度在孕龄30至38周期间经历快速线性生长，之后生长几乎停止。随着研究人员开始了解脉络膜发育在人类婴儿眼部和视网膜健康中的作用，这些基础测量以及确定低出生体重和早产极端情况对脉络膜发育的影响将至关重要。
在本文末尾的脚注和披露中可能会发现专有或商业披露信息。
