July 2019
Volume 60, Issue 9
Open Access
ARVO Annual Meeting Abstract  |   July 2019
Visual outcomes and optical coherence tomography features in young adults born extremely preterm: The EPICure@19 Study
Author Affiliations & Notes
  • Siva Balasubramanian
    Doheny Eye Institute, Los Angeles, California, United States
  • Saurabh Jain
    Ophthalmology, Royal Free London NHS Foundation Trust, London, United Kingdom
  • Joanne Beckmann
    Academic Neonatology, UCL Elizabeth Garrett Anderson Institute for Women’s Health, University College London, London, United Kingdom
  • Karntida Chanwimol
    Doheny Eye Institute, Los Angeles, California, United States
  • Marco Nassisi
    Doheny Eye Institute, Los Angeles, California, United States
  • Irena Tsui
    Doheny Eye Institute, Los Angeles, California, United States
    Ophthalmology, David Geffen School of Medicine at UCLA, Los Angeles, California, United States
  • Neil Marlow
    Academic Neonatology, UCL Elizabeth Garrett Anderson Institute for Women’s Health, University College London, London, United Kingdom
  • Srinivas R Sadda
    Doheny Eye Institute, Los Angeles, California, United States
    Ophthalmology, David Geffen School of Medicine at UCLA, Los Angeles, California, United States
  • Hemal Mehta
    Ophthalmology, Royal Free London NHS Foundation Trust, London, United Kingdom
    Macular Research Group, University of Sydney, Sydney, New South Wales, Australia
  • Footnotes
    Commercial Relationships   Siva Balasubramanian, None; Saurabh Jain, None; Joanne Beckmann, None; Karntida Chanwimol, None; Marco Nassisi, None; Irena Tsui, None; Neil Marlow, Novartis, Shire (C); Srinivas Sadda, Allergan, Carl Zeiss Meditec, Genentech, Iconic, Novartis, Optos, Optovue, Regeneron, Thrombogenics, Centervue, Heidelberg (C), Allergan, Carl Zeiss Meditec, Genentech, Iconic, Novartis, Optos, Optovue, Regeneron, Thrombogenics, Centervue, Heidelberg (F); Hemal Mehta, e Bayer, Novartis, Allergan, Heidelberg, Alimera Sciences (C), e Bayer, Novartis, Allergan, Heidelberg, Alimera Sciences (F)
  • Footnotes
    Support  None
Investigative Ophthalmology & Visual Science July 2019, Vol.60, 4754. doi:https://doi.org/
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      Siva Balasubramanian, Saurabh Jain, Joanne Beckmann, Karntida Chanwimol, Marco Nassisi, Irena Tsui, Neil Marlow, Srinivas R Sadda, Hemal Mehta; Visual outcomes and optical coherence tomography features in young adults born extremely preterm: The EPICure@19 Study. Invest. Ophthalmol. Vis. Sci. 2019;60(9):4754. doi: https://doi.org/.

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      © ARVO (1962-2015); The Authors (2016-present)

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Abstract

Purpose : Preterm children have an increased risk of impaired vision from retinopathy of prematurity (ROP). Optical coherence tomography (OCT) studies have confirmed abnormal foveal development in preterm children. We investigated the relationship between chorioretinal morphological parameters and visual function in young adults born extremely preterm (EP).

Methods : In this prospective observational study, a total of 354 eyes (226 eyes of former EP infants born before 26 weeks and 128 age-matched full-term control eyes) from 177 young adults were evaluated at the age of 19 years. Subjects underwent eye examinations including best-corrected visual acuity (BCVA) and Heidelberg Spectralis OCT imaging. Macular retinal layers (Fig 1A) and the peripapillary retinal nerve fiber layer (RNFL; Fig 1B) were auto-segmented to compute thickness profiles. Choroidal area (CA), luminal area (LA), stromal area (SA) and choroidal vascularity index (CVI) were measured on a central horizontal B-scan (Fig 1C).

Results : Among the EP group, 50% were not diagnosed with ROP, 37% had ROP not treated previously and 13% had ROP treated previously with laser or cryotherapy. The inner retinal layer (IRL) and outer retinal layer (ORL) thickness were significantly (p<0.001) increased in EP compared with controls. IRL was positively correlated with logMAR BCVA but ORL was not. Multiple linear regression model analysis identified ganglion cell layer thickness as a significant predictor of logMAR BCVA (p < 0.001). Peripapillary RNFL thickness was significantly (p<0.0001) lower in EP compared with controls. LogMAR BCVA was negatively correlated to the nasal inferior sector (NI) of RNFL thickness and multivariable regression indicated that RNFT-NI thickness was a significant (p < 0.0001) predictor of logMAR.
The CA (p = 0.007), LA (p = 0.004) and SA (p = 0.03) were significantly decreased in the EP group compared with controls. There was no significant difference in CVI between groups. LogMAR BCVA was negatively related to choroidal LA and multivariable regression indicated that LA was a significant (p = 0.004) predictor of logMAR BCVA.

Conclusions : Following extremely preterm birth, at 19 years of age, the retina and choroid appear to be profoundly altered and associated with impaired vision. Further longitudinal studies are required to study the evolution of these retinal and choroidal changes over time.

This abstract was presented at the 2019 ARVO Annual Meeting, held in Vancouver, Canada, April 28 - May 2, 2019.

 

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