Association between optic nerve and macular morphology by handheld spectral domain optical coherence tomography and intracranial pathology in preterm infants

Abstract

Purpose : Intracranial disease is frequently observed in premature infants, potentially impacting neural tissue in the eye. This study investigates optic disc and macular morphology using handheld spectral domain-optical coherence tomography (SD-OCT) in preterm infants with and without radiographic brain pathology.

Methods : In this prospective observational study, premature newborns screened for retinopathy of prematurity underwent handheld SD-OCT at 36 weeks postmenstrual age. Quantitative optic nerve and macular OCT analysis was conducted in a semiautomated manner. Optic nerve parameters included disc diameter, cup diameter, maximal cup depth, and peripapillary retinal nerve fiber layer (RNFL) thickness. Macular RNFL, ganglion cell layer (GCL), inner plexiform layer (IPL), and whole retinal thicknesses were measured paracentrally at 250 um from center and 500 – 2000 um from center. OCT measurements and demographics were compared between those with and without brain pathology on head ultrasound using a student’s T-test for continuous variables and chi-square test for categorical variables.

Results : A total of 69 patients (34 females, 138 eyes) were included. Average gestational age was 27.99 ± 2.57 weeks and birth weight was 982.7 ± 277.4 grams. Fifteen patients (21.7%) developed brain pathology, all of which manifested as intraventricular hemorrhage (IVH). Patients with IVH had lower gestational age and birth weight compared to those without IVH (26.22±2.62 versus. 28.48±2.35, p=0.002 and 849.1 ± 280.7 versus. 1019.8 ± 267.3, p= 0.034, respectively). The macular paracentral thicknesses at 250 um were greater for those with IVH compared to those without for RNFL (8.9±4.0 versus. 6.8 ±3.4, p=0.024)
, GCL (10.1±5.8 versus. 7.2±4.4, p=0.018), and IPL (31.0±10.5 versus. 24.4±6.8, p=0.019). Macular paracentral thicknesses at 500 – 2000 um and disc parameters were not different between the two groups.

Conclusions : Preterm infants with IVH had thicker paracentral macular retinal layers at 250 um from center compared to those without IVH while optic disc morphology and peripapillary RNFL thicknesses were not different. The potential contribution of gestational age to this relationship cannot be ruled out.

This abstract was presented at the 2024 ARVO Annual Meeting, held in Seattle, WA, May 5-9, 2024.