From the Department of Ophthalmology, University Medical Center of the Johannes Gutenberg University Mainz (A.F., S.G., E.M.H., P.L., B.S., N.P., A.H., A.K.S.), Mainz, Germany.
From the Department of Ophthalmology, University Medical Center of the Johannes Gutenberg University Mainz (A.F., S.G., E.M.H., P.L., B.S., N.P., A.H., A.K.S.), Mainz, Germany.
Am J Ophthalmol. 2024 Jun;262:170-177. doi: 10.1016/j.ajo.2024.02.008. Epub 2024 Feb 14.
This study explores associations between fetal growth restriction or excessive fetal growth, along with perinatal factors on the optic nerve head morphology in adulthood.
Retrospective cohort study.
This retrospective cohort study involved a prospective ophthalmological examination of individuals born at full term (with a gestational age of ≥37 weeks) from 1969 to 2002. Each participant underwent nonmydriatic fundus camera photography to capture images of the optic discs, followed by manual measurements. The vertical cup-to-disc ratio (VCDR) and optic disc area were examined and analyzed in relation to the baby's birth weight relative to the gestational age. These categories included those with former moderate (birth weight percentile between the 3rd and <10th), severe SGA (below the third percentile), normal (AGA, 10th-90th percentile), and moderately (birth weight >90th-97th percentile) and severely (birth weight >97th percentile) large for gestational age (LGA) adults within the age range of 18 to 52 years.
Overall, 535 eyes of 280 individuals (age 29.7 ± 9.2 years, 144 females) born at full term were included. Multivariable analysis showed a significant association between a larger VCDR and the severe SGA group (B = 0.05, 95% CI 0.01-0.10; P = .02). In the univariable model, placental insufficiency was associated with VCDR (B = 0.10, 95% CI 0.01-0.19; P = .03). Other perinatal factors did not demonstrate an association with VCDR. Furthermore, there was an indication of an association suggesting a smaller optic disc area in individuals born moderately SGA at full term (B = -0.17, 95% CI -0.33 to -0.001; P = .05).
This study provides evidence that individuals born at-term with severe SGA have an increased VCDR, suggesting that fetal growth restriction has a lasting impact on optic disc morphology independent of prematurity throughout adulthood.
本研究旨在探讨胎儿生长受限或过度生长以及围产期因素与成人视神经乳头形态之间的关系。
回顾性队列研究。
本回顾性队列研究纳入了 1969 年至 2002 年足月（胎龄≥37 周）出生的个体进行前瞻性眼科检查。每个参与者均接受非散瞳眼底相机拍摄眼底图像，并进行手动测量。检查和分析垂直杯盘比（VCDR）和视盘面积与婴儿出生体重相对于胎龄的关系。这些类别包括以前的中度（出生体重百分位数在第 3 至<第 10 位之间）、严重的 SGA（低于第 3 百分位）、正常（AGA，第 10-90 位）、中度（出生体重>第 90-97 位）和重度（出生体重>第 97 位）大于胎龄（LGA）的成年人，年龄在 18 至 52 岁之间。
共有 280 名个体（年龄 29.7±9.2 岁，女性 144 名）的 535 只眼足月出生，纳入本研究。多变量分析显示，较大的 VCDR 与严重的 SGA 组显著相关（B=0.05，95%CI 0.01-0.10；P=0.02）。在单变量模型中，胎盘功能不全与 VCDR 相关（B=0.10，95%CI 0.01-0.19；P=0.03）。其他围产期因素与 VCDR 无相关性。此外，有迹象表明，足月出生的中度 SGA 个体的视盘面积较小（B=-0.17，95%CI -0.33 至 -0.001；P=0.05）。
本研究表明，足月出生的严重 SGA 个体 VCDR 增加，提示胎儿生长受限对成年后视神经乳头形态的影响持续存在，与早产无关。
