TY - JOUR T1 - Associations between systemic health and retinal nerve fibre layer thickness in preterm infants at 36 weeks postmenstrual age JF - British Journal of Ophthalmology JO - Br J Ophthalmol DO - 10.1136/bjophthalmol-2021-319254 SP - bjophthalmol-2021-319254 AU - Liangbo L Shen AU - Shwetha Mangalesh AU - Suzanne M Michalak AU - Brendan McGeehan AU - Neeru Sarin AU - Joanne Finkle AU - Katrina P Winter AU - Du Tran-Viet AU - Eric J Benner AU - Lejla Vajzovic AU - Sharon F Freedman AU - Noelle Younge AU - C Michael Cotten AU - Mays El-Dairi AU - Gui-Shuang Ying AU - Cynthia Toth Y1 - 2021/08/13 UR - http://bjo.bmj.com/content/early/2022/07/07/bjophthalmol-2021-319254.abstract N2 - Background/aims Neonatal insults from systemic diseases have been implicated in the pathway of impaired neurodevelopment in preterm infants. We aimed to investigate the associations between systemic health factors and retinal nerve fibre layer (RNFL) thickness in preterm infants.Methods We prospectively enrolled infants and imaged both eyes at 36±1 weeks postmenstrual age (PMA) using a hand-held optical coherence tomography system at the bedside in the Duke intensive care nurseries. We evaluated associations between RNFL thickness and 29 systemic health factors using univariable and multivariable regression models.Results 83 infants with RNFL thickness measures were included in this study. Based on the multivariable model, RNFL thickness was positively associated with infant weight at imaging and was negatively associated with sepsis/necrotising enterocolitis (NEC). RNFL thickness was 10.4 µm (95% CI −15.9 to −4.9) lower in infants with than without sepsis/NEC in the univariable analysis (p<0.001). This difference remained statistically significant after adjustment for confounding variables in various combinations (birth weight, birthweight percentile, gestational age, infant weight at imaging and growth velocity). A 250 g increase in infant weight at imaging was associated with a 3.1 µm (95% CI 2.1 to 4.2) increase in RNFL thickness in the univariable analysis (p<0.001).Conclusions Low infant weight and sepsis/NEC were independently associated with thinner RNFL in preterm infants at 36 weeks PMA. To our knowledge, this study is the first to suggest that sepsis/NEC may affect retinal neurodevelopment. Future longitudinal studies are needed to investigate this relationship further.Data are available on reasonable request. The raw data in our study are available on reasonable request sent to the corresponding author. ER -