BACKGROUND: Vascularisation of the macula takes place between 24 and 27 weeks post-conception. Preterm birth may affect the formation of the foveal avascular zone (FAZ) and foveal depression, and displacement of inner retinal layers away from the incipient fovea. OBJECTIVE: To examine whether vascular abnormalities accompany an inner retinal abnormality, and whether they are coincident. METHODS: High-density spectral domain optical coherence tomography volume scans were obtained from 24 preterm children and 34 full-term controls (5-16 years). Matlab programs were used to quantify total retinal thickness, thickness of individual retinal layers and metrics of foveal morphology. Summed voxel projections for the ganglion cell layer-inner nuclear layer were used to identify the FAZ. RESULTS: Preterm children had significantly smaller FAZ diameters than controls (p<0.0001). The foveal pits of preterm children were significantly shallower and less steep (p<0.0001) and total retinal thickness at the fovea was significantly increased (p<0.0001) compared to controls. The ganglion cell layer-inner plexiform layer and outer nuclear layer were significantly (p≤0.0001) thicker in preterm children than in controls. CONCLUSIONS: Preterm birth results in abnormal foveal vascularisation, a failure of the inner retinal neurons to migrate away from the fovea, and an elevated outer nuclear layer ratio. The spatial coincidence of inner retinal and vascular abnormalities in preterm children supports the hypothesis that aspects of foveal development are interdependent.
BACKGROUND: Vascularisation of the macula takes place between 24 and 27 weeks post-conception. Preterm birth may affect the formation of the foveal avascular zone (FAZ) and foveal depression, and displacement of inner retinal layers away from the incipient fovea. OBJECTIVE: To examine whether vascular abnormalities accompany an inner retinal abnormality, and whether they are coincident. METHODS: High-density spectral domain optical coherence tomography volume scans were obtained from 24 preterm children and 34 full-term controls (5-16 years). Matlab programs were used to quantify total retinal thickness, thickness of individual retinal layers and metrics of foveal morphology. Summed voxel projections for the ganglion cell layer-inner nuclear layer were used to identify the FAZ. RESULTS: Preterm children had significantly smaller FAZ diameters than controls (p<0.0001). The foveal pits of preterm children were significantly shallower and less steep (p<0.0001) and total retinal thickness at the fovea was significantly increased (p<0.0001) compared to controls. The ganglion cell layer-inner plexiform layer and outer nuclear layer were significantly (p≤0.0001) thicker in preterm children than in controls. CONCLUSIONS: Preterm birth results in abnormal foveal vascularisation, a failure of the inner retinal neurons to migrate away from the fovea, and an elevated outer nuclear layer ratio. The spatial coincidence of inner retinal and vascular abnormalities in preterm children supports the hypothesis that aspects of foveal development are interdependent.
Authors: Achim Fieß; Johannes Janz; Alexander K Schuster; Ruth Kölb-Keerl; Markus Knuf; Bernd Kirchhof; Philipp S Muether; Jacqueline Bauer Journal: Graefes Arch Clin Exp Ophthalmol Date: 2017-04-25 Impact factor: 3.117
Authors: Melissa A Wilk; Brandon M Wilk; Christopher S Langlo; Robert F Cooper; Joseph Carroll Journal: Vision Res Date: 2016-12-02 Impact factor: 1.886
Authors: Anna E C Molnar; Sten O Andréasson; Eva K B Larsson; Hanna M Åkerblom; Gerd E Holmström Journal: JAMA Ophthalmol Date: 2017-08-01 Impact factor: 7.389
Authors: Lejla Vajzovic; Adam L Rothman; Du Tran-Viet; Michelle T Cabrera; Sharon F Freedman; Cynthia A Toth Journal: Invest Ophthalmol Vis Sci Date: 2015-01-13 Impact factor: 4.799