uu.seUppsala University Publications
Change search
CiteExportLink to record
Permanent link

Direct link
Cite
Citation style
  • apa
  • ieee
  • modern-language-association
  • vancouver
  • Other style
More styles
Language
  • de-DE
  • en-GB
  • en-US
  • fi-FI
  • nn-NO
  • nn-NB
  • sv-SE
  • Other locale
More languages
Output format
  • html
  • text
  • asciidoc
  • rtf
Central macular thickness in 6.5-year-old children born extremely preterm is strongly associated with gestational age even when adjusted for risk factors
Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Neuroscience, Ophthalmology. (Oftalmiatrik/Ophthalmology)
Department of Clinical Neuroscience, Karolinska Institutet.
Department of Clinical Neuroscience, Karolinska Institutet.
Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Neuroscience, Ophthalmology. (Oftalmiatrik/Ophthalmology)
Show others and affiliations
2017 (English)In: Retina, ISSN 0275-004X, E-ISSN 1539-2864, Vol. 37, no 12, p. 2281-2288Article in journal (Refereed) Published
Abstract [en]

Purpose:To assess the macular thickness in 6.5-year-old children born extremelypreterm (EPT) in comparison with children born at term and to investigate risk factorsassociated with the macular thickness in the preterm group.

Methods:A population-based study of 6.5-year-old children born before the gestationalage of 27 weeks and age-matched control subjects. Macular assessments with opticalcoherence tomography were performed, and the results were compared with neonatal riskfactors and sex.

Results:Adequate optical coherence tomography measurements were obtained from134 children born EPT (mean gestational age of 25 weeks [range 23–26]) and 145 controlsubjects. The mean (range) of central macula thickness was significantly increased (P,0.001)in the EPT group (right eyes: 282mm [238–356], left eyes: 283mm[229–351]), compared withthe control group (right eyes: 249mm [208–293], left eyes: 248mm[207–290]). A multiple linearmixed model analysis of the EPT group revealed gestational age, retinopathy of prematurity,and male gender as important risk factors for an increased macular thickness. The macularthickness decreased by 3.9mm per gestational week, when adjusted for retinopathy of pre-maturity and sex.

Conclusion:Extremely preterm birth constitutes a substantial risk factor for a thickcentral macula, even when adjusted for retinopathy of prematurity and male gender.

Place, publisher, year, edition, pages
Lippincott Williams & Wilkins, 2017. Vol. 37, no 12, p. 2281-2288
National Category
Ophthalmology
Research subject
Ophtalmology
Identifiers
URN: urn:nbn:se:uu:diva-317548DOI: 10.1097/IAE.0000000000001469ISI: 000425214400009PubMedID: 28098724OAI: oai:DiVA.org:uu-317548DiVA, id: diva2:1082246
Funder
Swedish Society of MedicineSven Jerring FoundationStockholm County Council
Available from: 2017-03-16 Created: 2017-03-16 Last updated: 2018-04-10Bibliographically approved
In thesis
1. Structure and Function of the Retina in Children Born Extremely Preterm and in Children Born At Term
Open this publication in new window or tab >>Structure and Function of the Retina in Children Born Extremely Preterm and in Children Born At Term
2017 (English)Doctoral thesis, comprehensive summary (Other academic)
Abstract [en]

Background: Optical coherence tomography (OCT), multifocal electroretinography (mfERG) and full-field electroretinography (ffERG) give important information about retinal structure and function.

Purpose: To collect normative data of macular Cirrus Spectral domain (SD)-OCT assessments and of mfERG measurements of healthy children (papers I and II). To assess the macular thickness with Cirrus SD-OCT and the retinal function with ffERG in 6.5-year-old children born extremely preterm and in children born at term (papers III and IV).

Methods: Study participants aged 5-15 years and living in Uppsala County were randomly chosen from the Swedish Birth Register (papers I and II). In papers III and IV, the study participants consisted of children born extremely preterm and children born at term – all were aged 6.5 years. In paper III, the children were living in Stockholm and Uppsala health care regions and, in paper IV, in Uppsala health care region only. Macular thickness was assessed with Cirrus SD-OCT and macular function with mfERG, using the Espion Multifocal system and DTL-electrodes. The retinal function was assessed with ffERG and DTL-electrodes, using the Espion Ganzfield system.

Results: Altogether, 58 children participated in paper I and 49 children in paper II. In paper I, the repeatability and reproducibility of the OCT assessments were good. In paper II, the results of the mfERG measurements were in accordance with retinal cone density and there were no significant differences between the right and left eyes. In paper III, 134 preterm children and 145 children born at term constituted the study population. The central macular thickness was significantly thicker in the preterm group than in the control group. Within the preterm group, gestational age (GA), former retinopathy of prematurity (ROP) and male gender were all important risk factors for an increased macular thickness. In paper IV, 52 preterm children and 45 control children constituted the study population. Significantly lower amplitudes and prolonged implicit times of the combined rod and cone responses, as well as of the isolated cone responses, were found in the preterm group when compared with the control group. In paper IV, there was no association between GA, ROP or male gender and the ffERG assessments.

Conclusion: Normative data of Cirrus SD-OCT and mfERG assessments were reported. The results of the assessments were reliable. Children aged 6.5 years, born extremely preterm, had a significantly thicker central macula and both rod and cone function were significantly reduced in comparison to children born at term. ROP had an influence on retinal structure but not retinal function in the present cohorts. Our results suggest that retinal development is abnormal in children born extremely preterm. Long-term follow-up studies are necessary in order to evaluate the functional ophthalmological outcome in this vulnerable population of children growing up today.

Place, publisher, year, edition, pages
Uppsala: Acta Universitatis Upsaliensis, 2017. p. 79
Series
Digital Comprehensive Summaries of Uppsala Dissertations from the Faculty of Medicine, ISSN 1651-6206 ; 1318
Keyword
optical coherence tomography, multifocal electroretinogram, full-field electroretinography, extremely preterm children, retinopathy of prematurity, gestational age, gender
National Category
Ophthalmology
Research subject
Ophtalmology
Identifiers
urn:nbn:se:uu:diva-317550 (URN)978-91-554-9862-7 (ISBN)
Public defence
2017-05-13, Gunnesalen, Psykiatrins hus, Ingång 10, Akademiska sjukhuset, Uppsala, 09:00 (English)
Opponent
Supervisors
Available from: 2017-04-21 Created: 2017-03-19 Last updated: 2017-05-05

Open Access in DiVA

No full text in DiVA

Other links

Publisher's full textPubMed

Authority records BETA

Molnar, AnnaLarsson, Eva K BHolmström, Gerd

Search in DiVA

By author/editor
Molnar, AnnaLarsson, Eva K BHolmström, Gerd
By organisation
Ophthalmology
In the same journal
Retina
Ophthalmology

Search outside of DiVA

GoogleGoogle Scholar

doi
pubmed
urn-nbn

Altmetric score

doi
pubmed
urn-nbn
Total: 379 hits
CiteExportLink to record
Permanent link

Direct link
Cite
Citation style
  • apa
  • ieee
  • modern-language-association
  • vancouver
  • Other style
More styles
Language
  • de-DE
  • en-GB
  • en-US
  • fi-FI
  • nn-NO
  • nn-NB
  • sv-SE
  • Other locale
More languages
Output format
  • html
  • text
  • asciidoc
  • rtf