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Retinal structure assessed by OCT as a biomarker of brain development in children born small for gestational age
  1. Victoria Pueyo1,
  2. Teresa Pérez1,
  3. Inmaculada González1,
  4. Irene Altemir1,
  5. Galadriel Gimenez1,
  6. Esther Prieto1,
  7. Cristina Paules2,
  8. Daniel Oros2,
  9. Javier Lopez-Pison3,
  10. Nicolás Fayed4,
  11. Gracián Garcia-Martí5,6,
  12. Roberto Sanz-Requena5,
  13. Miguel Angel Marin7
  1. 1Aragon Institute for Health Research (IIS Aragón), Ophthalmology Department, Miguel Servet University Hospital, Zaragoza, Spain
  2. 2Aragon Institute for Health Research (IIS Aragón), Obstetrics Department, Hospital Clínico Universitario Zaragoza, Zaragoza, Spain
  3. 3Aragon Institute for Health Research (IIS Aragón), Neuropaediatric Unit, Miguel Servet University Hospital, Zaragoza, Spain
  4. 4Radiology Department, Quirónsalud Hospital, Zaragoza, Spain
  5. 5Unidad de Ingeniería Biomédica. Hospital Quirónsalud, Valencia, Spain
  6. 6CIBERSAM, Institute of Health Carlos III, Valencia, Spain
  7. 7Aragon Institute for Health Research (IIS Aragón), Radiolology Department, Miguel Servet University Hospital, Zaragoza, Spain
  1. Correspondence to Dr Victoria Pueyo, Ophthalmology Department, Miguel Servet University Hospital, Pso, Isabel la Católica 3, Zaragoza 50009 ,Spain; vicpueyo{at}


Purpose To identify differences in neuronal tissue from retinal and brain structures in children born small for gestational age (SGA) with no abnormality in neonatal brain ultrasonography and no previous neurological impairment, and to evaluate the relationship between retinal structure and brain changes in school-age children born SGA.

Methods Two cohorts of children were recruited: 25 children born SGA and 25 children born with an appropriate birth weight according to gestational age. All the children underwent an ophthalmic examination, which included retinal imaging using spectral-domain optical coherence tomography, and a brain MRI. MRI images were automatically segmented and global and regional brain volumes were obtained.

Results Although visual function did not differ between both groups, the complex ganglion cell and inner plexiform layers (GCL-IPL) was thinner in SGA children. Total intracranial volume, and global grey and white matter volumes in brain and cerebellum were correlated with birthweight centile, as were certain regional volumes (temporal and parietal lobes, hippocampus and putamen). Abnormal GCL-IPL measurements accurately identified SGA children with the most severe grey and white matter changes in the brain.

Conclusions SGA children, both preterm and term born, showed evidence of structural abnormalities in the retina, which may be an accurate and non-invasive biomarker of neuronal damage in brain tissue.

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

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  • Contributors Design and conduct of the study: VP, JL-P and MAM. Collection, management and interpretation of the data: VP, TP, IG, IA, EP, GG, RS-R, CP, DO, NF and GG-M. Preparation and review of the manuscript: VP, JL-P, MAM, TP, IG, IA, EP, GG, CP, DO, NF, GG-M and RS-R.

  • Funding The Spanish government (PI11/02430). RETICS funded by the PN I+D+I 2008–2011 (Spain), ISCIII- Sub-Directorate General for Research Assessment and Promotion and the European Regional Development Fund (ERDF), ref. RD12/0026.

  • Competing interests None declared.

  • Patient consent Written informed consent was obtained from the parents or guardians of each child.

  • Ethics approval Comité ético de Investigación clínica de Aragón (CEICA).

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

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