The long-term influence of perinatal factors on macular morphology and vessel density in preterm children

• Published in: Early human development Vol. 192; p. 105993
• Main Authors: Czeszyk, Agnieszka, Hautz, Wojciech, Bulsiewicz, Dorota, Jaworski, Maciej, Czech-Kowalska, Justyna
• Format: Journal Article
• Language: English
• Published: Ireland Elsevier B.V 01.05.2024
• Subjects: Choroidal thickness; Foveal avascular zone; Optical coherence tomography angiography; Prematurity; Retinal thickness; Retinal vessel density; Choroidal thickness; Optical coherence tomography angiography; Prematurity; Retinal thickness; Retinal vessel density; Foveal avascular zone
• ISSN: 0378-3782; 1872-6232
• DOI: 10.1016/j.earlhumdev.2024.105993

Increased survival rate of extremely preterm children is associated with a higher risk of retinopathy of prematurity (ROP) and long-term sequelae, which implicate retinal changes. To assess an influence of perinatal characteristics on morphology and retinal vascularity of the macula in preterm children. A cohort of 123 preterm children at the age of 10.5 years (IQR: 8.12-12.77) was prospectively assessed. Optical coherence tomography angiography (OCTA) was performed using RTVueXR Avanti. Foveal thickness, parafoveal thickness, size of foveal avascular zone (FAZ), superficial and deep vessel density, central choroidal thickness (CCT) were analyzed. The associations between OCTA results and perinatal factors, including the presence of ROP and therapy requirements were assessed in preterm children. Significantly smaller FAZ, higher foveal thickness and vessel density were noted in children with ROP, Respiratory Distress Syndrome, Bronchopulmonary Dysplasia, required erythropoietin, transfusion or steroids. Foveal thickness was increased in children with ROP (p < 0.001) and following laser treatment (p < 0.05). Thinner CCT was noted in children with a history of sepsis (p < 0.05) and ROP required treatment (p < 0.05). Pregnancy bleeding was associated with higher superficial foveal vessel density (p < 0.05) and smaller FAZ (p < 0.05). Neonatal factors have a huge impact on retinal development, but the role of prenatal factors should not be neglected in preterm children. •Prematurity has a negative impact on the morphology and vascularization of the retina, which affects visual acuity.•Structural and vascular changes of the macula are related not only to retinopathy of prematurity but also to other complications of prematurity.•Maternal, but also neonatal, factors should be taken into account in qualifications for ophthalmic exam.