June 2023
Volume 64, Issue 8
Open Access
ARVO Annual Meeting Abstract  |   June 2023
Effect of prematurity on foveal development persists through infancy
Author Affiliations & Notes
  • Xiao Yi Zhou
    Ophthalmology, Duke University, Durham, North Carolina, United States
  • Gui-Shuang Ying
    University of Pennsylvania Perelman School of Medicine, Philadelphia, Pennsylvania, United States
  • Vincent Tai
    Ophthalmology, Duke University, Durham, North Carolina, United States
  • Shwetha Mangalesh
    Ophthalmology, Duke University, Durham, North Carolina, United States
  • Cynthia A Toth
    Ophthalmology, Duke University, Durham, North Carolina, United States
  • Xi Chen
    Ophthalmology, Duke University, Durham, North Carolina, United States
  • Footnotes
    Commercial Relationships   Xiao Yi Zhou None; Gui-Shuang Ying None; Vincent Tai None; Shwetha Mangalesh None; Cynthia Toth Alcon, Code R (Recipient); Xi Chen None
  • Footnotes
    Support  NIH grant R01EY025009 (Toth), R01EY034134 (Chen), P30EY005722 (Duke Core)
Investigative Ophthalmology & Visual Science June 2023, Vol.64, 5428. doi:
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    • Get Citation

      Xiao Yi Zhou, Gui-Shuang Ying, Vincent Tai, Shwetha Mangalesh, Cynthia A Toth, Xi Chen; Effect of prematurity on foveal development persists through infancy. Invest. Ophthalmol. Vis. Sci. 2023;64(8):5428.

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

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Abstract

Purpose : Foveation and inner retinal displacement are arrested in extremely premature infants through term equivalent age. We hypothesize that the effect of prematurity on foveal development persists through the first year of life.

Methods : Infants enrolled in the STudy of Eye imaging in Preterm infantS (BabySTEPS; NCT02887157) were imaged with handheld optical coherence tomography (OCT) at 4- and 9-month corrected age. The foveal and parafoveal inner and outer retinal thicknesses were measured and parafoveal-to-foveal thickness (P/F) ratios were calculated. Univariate and multivariate regression analyses were performed to determine factors associated with P/F ratio, and to determine the effect of gestational age (GA) on foveal thickness measurements.

Results : The study included 99 eyes from 56 preterm infants at 4 months and 73 eyes from 45 infants at 9 months with gradable foveal OCT scans. In univariate analysis, decreased P/F ratio at 4 and 9 months was significantly associated with lower GA (p<0.0001), lower birth weight (p<0.0001), higher maximum retinopathy of prematurity (ROP) stage (p<0.0001 for 4 months, p=0.01 for 9 months), and ROP requiring treatment (p=0.003 for 4 months and p=0.01 for 9 months), while P/F ratio was not associated with sex, race or ethnicity. With multivariate analysis, only GA remained significantly associated with decreased P/F ratio at both 4 months and 9 months. No significant macular edema (inner nuclear layer thickness over 75 μm) was noted in either 4- or 9-month infant eyes. The foveal inner retinal layer thickness was significantly thicker in more prematurely born infants at both 4 months (linear regression coefficient β (standard error (SE)) = 6.07 (0.76) μm per week GA decrease, p<0.0001) and 9 months PMA (β (SE) = 4.46 (0.84) μm per week GA decrease, p=0.002). The foveal outer retinal layer thickness was also significantly thicker in more premature infants at both 4 months (β (SE) = 5.28 (1.14) μm per week GA decrease, p=0.001) and 9 months (β (SE) = 5.50 (1.10) μm per week GA decrease, p=0.002).

Conclusions : The effect of prematurity on foveal development persists through the first year of life and is most pronounced in the extremely premature infants. Development of both the inner and outer retina is altered in prematurity, and manifests from the time of preterm birth through infancy.

This abstract was presented at the 2023 ARVO Annual Meeting, held in New Orleans, LA, April 23-27, 2023.

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