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Sasapin Grace Prakalapakorn, Nikhil Sarin, Neeru Sarin, Brendan McGeehan, Sharon F Freedman, Cynthia A Toth; Evaluating the effect of prematurity and retinopathy of prematurity disease severity on change in axial length over time. Invest. Ophthalmol. Vis. Sci. 2019;60(9):6517. doi: https://doi.org/.
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© ARVO (1962-2015); The Authors (2016-present)
To study how factors related to prematurity and severity of retinopathy of prematurity (ROP) affect the change of axial length over time in premature infants.
This study was conducted as part of a larger prospective study evaluating the microanatomy of the developing retina and optic nerve in preterm infants and its relationship to brain development, neurodevelopment, visual function and ROP. We prospectively enrolled infants undergoing routine ROP screening in the neonatal intensive care unit at an academic center. After routine ROP screening was performed with indirect ophthalmoscopy by a fellowship-trained ophthalmologist, an A-scan (Sonomed Master-Vu® A-Scan) was used to measure the axial length of both eyes. We evaluated the change in axial length over time by gestational age (GA), birthweight (BW), and severity of ROP (less severe = highest stage of ROP of 0 or 1; more severe = highest stage of ROP of 2 or 3 ROP or need for treatment). Generalized estimating equations were used to model change in axial length over time in order to take into account inter-eye correlation and an unequal number of measurements per infant. All statistical analysis was performed using R version 3.5.1(https://www.r-project.org).
Of 62 infants who had axial lengths measured, 5 (8%) were treated for ROP. Average GA was 28.0 weeks (SD=1.9; range: 24.0-31.7) and BW was 966g (SD=268, range: 490-1580). Looking at change in axial length over time, we found no interaction between post-menstrual age (PMA) and GA (p=0.98), PMA and BW (p=0.89), or PMA and severity of ROP (p=0.076). In the fully adjusted model, we found that axial length was longer with increasing PMA (p<0.001) and higher BW (p<0.001) and shorter with more severe ROP (p=0.049). GA did not affect axial length (p=0.89).
Among premature infants, those with the most severe ROP had the shortest axial lengths. These findings are important to take into account when performing imaging techniques that may be affected by axial length (e.g. optical coherence tomography), especially in those infants with more severe ROP who may have shorter axial lengths compared to those who did not develop severe ROP. This is critical as the infants with more severe disease are the infants that would more likely need imaging performed as part of their clinical care to help guide treatment.
This abstract was presented at the 2019 ARVO Annual Meeting, held in Vancouver, Canada, April 28 - May 2, 2019.
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