Abstract
Purpose :
To evaluate the association between optical coherence tomography (OCT)-based retinal microanatomical findings in the nursery and 2-year neurodevelopmental measures in preterm infants.
Methods :
As part of BabySTEPS (STudy of Eye imaging in Preterm infantS), infants at risk for retinopathy of prematurity (ROP) had bedside imaging in the nursery with an investigational handheld OCT system. Thickness of peripapillary retinal nerve fiber layer (RNFL), center foveal inner nuclear layer, inner retina, total retina, and 1mm choroid were measured from OCT images closest to 36 weeks (34-38) postmenstrual age (PMA). Neurodevelopmental assessments at 2-years corrected age included cognitive, language, and motor development scales of the Bayley Scales of Infant and Toddler Development – 3rd Edition (BSID) and the parent rated Child Behavior Checklist (CBCL) and Modified Checklist for Autism in Toddlers-Revised (MCHAT-R). Multivariable linear regression models were used to evaluate associations between retinal microanatomy measures at 34-38 weeks PMA and 2-year neurodevelopmental measures, with adjustment by birth weight, gestational age, PMA of imaging, and mother’s highest education level.
Results :
Of 98 children with at least 1 OCT imaging session in 34-38 weeks PMA, 72 returned for the 2-year assessment. In multivariable analysis (see Table), RNFL thickness was associated with BSID Cognitive (p=0.046) and Motor (p=0.0001) composite scores, and MCHAT-R score (p=0.04). Greater inner retina thickness was associated with lower CBCL Internalizing problems score (p=0.04). In univariable analysis, greater choroid thickness was associated with higher BSID Cognitive (p=0.0004), Language (p=0.004), and Motor (p=0.0004) composite scores, and lower MCHAT score (p=0.04); but these did not remain significant with multivariable analysis.
Conclusions :
Greater RNFL thickness at 34-38 weeks PMA was associated with higher cognitive and motor development scores and lower autism risk score at age 2 for preterm infants. Thinner RNFL in preterm infants was recently associated with poorer visual acuity at 9 months. These current findings point to the potential for RNFL (comprised of axons which extend to the lateral geniculate nucleus) as a marker either of parallel neurodevelopment, or of visual function and its impact on neurodevelopment in preterm infants.
This abstract was presented at the 2023 ARVO Annual Meeting, held in New Orleans, LA, April 23-27, 2023.