Abstract
Purpose :
History of premature birth (HoPB) is increasingly common and associated with retinal detachment in adulthood, lower single-surgery reattachment success, and poorer final visual acuity outcomes. However, many adults are unaware of their HoPB status, which makes screening challenging. Our group has shown that adults with HoPB have decreased foveal avascular zone (FAZ) on optical coherence tomography angiography (OCT-A) as compared to non-premature controls. However, OCT is more readily available in many clinical settings. Our aim is to determine if adults with HoPB have distinct findings on OCT that could facilitate screening for this risk factor in most clinical contexts.
Methods :
Retrospective single institutional analysis. Patients were chosen based on self-reported history of premature or full-term birth. All patients were already presenting to our Retina Clinic for routine care between 2019 and 2022. A representative OCT was selected for each patient and the following parameters were analyzed: central subfield thickness (CST), average cube thickness (ACT), and CST:ACT ratio. The central horizontal foveal B-scan was analyzed for the foveal pit depth to macular width (FPD:MW) ratio.
Results :
Twenty-four adults with HoPB (24 eyes) were compared to 24 adults with history of full-term birth (24 eyes). The cohort was 62.5% female and an average age of 56 years. Compared with controls, adults with HoPB had (1) significantly larger CST:ACT ratio (1.00 vs. 0.91, P: 0.005), (2) significantly thicker CST (270 um vs. 251 um, P: 0.049), and (3) significantly reduced FPD:MW ratio (0.051 vs. 0.066, P: 0.005). No significant difference in ACT was found.
Conclusions :
Our findings demonstrate structural foveal and macular differences on OCT in HoPB adults as compared to adults who were born full-term. These findings, combined with our prior findings that demonstrate changes in FAZ of HoPB adults, indicate that premature birth is associated with retinal structural and vascular changes that last into adulthood. These findings are consistent with findings reported previously in the premature pediatric population but have not yet been reported in adults. These changes warrant further analysis that may explain the retinal pathology and poorer visual outcomes seen in this population. These OCT findings may also facilitate screening for HoPB preoperatively, which could guide surgical planning and prognostic discussions.
This abstract was presented at the 2023 ARVO Annual Meeting, held in New Orleans, LA, April 23-27, 2023.