Article Text

Download PDFPDF
Functional analysis and associated factors of the peripapillary retinal nerve fibre layer in former preterm and full-term infants
  1. Achim Fieß1,
  2. Luka Christian2,
  3. Johannes Janz2,
  4. Ruth Kölb-Keerl1,
  5. Markus Knuf2,
  6. Bernd Kirchhof3,
  7. Philipp S Muether3,
  8. Jacqueline Bauer2,
  9. Prematurity Eye Study Group
    1. 1Department of Ophthalmology, Helios Dr Horst Schmidt Klinik, Wiesbaden, Germany
    2. 2Department of Paediatrics, Helios Dr Horst Schmidt Klinik, Wiesbaden, Germany
    3. 3Department of Ophthalmology, University of Cologne, Cologne, Germany
    1. Correspondence to Dr Achim Fieß, Department of Ophthalmology, Helios Dr Horst Schmidt Klinik Wiesbaden, Ludwig-Erhard-Straße 100, Wiesbaden 65199, Germany; Achim.Fiess{at}


    Purpose The aim of the study was to investigate peripapillary retinal nerve fibre layer thickness (RNFLT) in former preterm infants and full-term neonates using spectral-domain optical coherence tomography (SD-OCT).

    Methods The prospective, controlled, cross-sectional, hospital-based study in a tertiary centre with maximum care examined 503 infants with a former gestational age (GA) of ≥37 and ≤32 weeks now aged between 4 and 10 years. In total, we analysed 432 participants with successful circular peripapillary RNFLT OCT measurements. Main outcome measures were RNFLT correlations to GA, birth weight, occurrence of retinopathy of prematurity (ROP), perinatal adverse events as well as functional correlation.

    Results Global RNFLT was thinner in infants with GA ≤28 weeks compared with infants with GA between 29 and 32 weeks (p=0.024), and to full-term neonates (p=0.007) independent of the occurrence of ROP. Multivariable analysis revealed that RNFLT was positively associated with higher birth weight and GA. Furthermore, a decrease of RNFLT was related to reduced visual function in all peripapillary sectors.

    Conclusions The main factors for retinal nerve fibre layer thinning are low birth weight and low GA. In addition, decreased RNFLT was associated with reduced visual function. This demonstrates that preterm infants are at high risk for peripapillary RNFL damage associated with reduced visual function.

    • Child health (paediatrics)
    • Imaging
    • Optic Nerve
    • Retina
    • Visual perception

    Statistics from

    Request Permissions

    If you wish to reuse any or all of this article please use the link below which will take you to the Copyright Clearance Center’s RightsLink service. You will be able to get a quick price and instant permission to reuse the content in many different ways.


    • Collaborators Serife Demirbas, Paula Divis Di Oliveira, Lisa Ernst, Shirin Ghafoori, Saskia Jordan, Petra Nikolic, David Scheele, Florian Tlucynski, Christine Zeymer.

    • Contributors Corresponding author AF. AF and JB designed the study. AF and LC did the data acquisition and AF, JB and PSM analysed the data. AF drafted the manuscript, all authors revised it critically and approved the final version. All authors agreed to be accountable for all aspects of the work.

    • Competing interests None declared.

    • Patient consent Parental/guardian consent obtained.

    • Ethics approval Physician Chamber Hessen, Germany.

    • Provenance and peer review Not commissioned; externally peer reviewed.

    • Data sharing statement Data of our study are not publicly available, for further information please contact JB.