RT Journal Article
SR Electronic
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
FD BMJ Publishing Group Ltd.
SP 242
OP 247
DO 10.1136/bjophthalmol-2021-319254
VO 107
IS 2
A1 Liangbo L Shen
A1 Shwetha Mangalesh
A1 Suzanne M Michalak
A1 Brendan McGeehan
A1 Neeru Sarin
A1 Joanne Finkle
A1 Katrina P Winter
A1 Du Tran-Viet
A1 Eric J Benner
A1 Lejla Vajzovic
A1 Sharon F Freedman
A1 Noelle Younge
A1 C Michael Cotten
A1 Mays El-Dairi
A1 Gui-Shuang Ying
A1 Cynthia Toth
YR 2023
UL http://bjo.bmj.com/content/107/2/242.abstract
AB 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.