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Retinal nerve fibre layer thickness in school-aged prematurely-born children compared to children born at term
Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Neuroscience, Ophthalmology.
Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Neuroscience, Ophthalmology.
Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Neuroscience, Ophthalmology.
2012 (English)In: British Journal of Ophthalmology, ISSN 0007-1161, E-ISSN 1468-2079, Vol. 96, no 7, 956-960 p.Article in journal (Refereed) Published
Abstract [en]

Aim To investigate the retinal nerve fibre layer (RNFL) with optical coherent tomography (OCT) in prematurely-born children. Methods 62 children born with a gestational age of <= 32 weeks, and a control group of 54 children born at term with normal birth weight (BW) were included in the study. 28 of the preterm children had retinopathy of prematurity (ROP) in the neonatal period; eight of them had severe ROP (stages 3-4). RNFL thickness was measured with Stratus OCT 3. Mean age at examination was 8.6 years in the preterm children and 10.1 years in the control group. Results There was a significant difference between the children born preterm and those born at term, regarding RNFL thickness in the superior (right eye (RE), p=0.043; left eye (LE), p=0.048) and the nasal quadrants (RE, p=0.006; LE, p<0.001), as well as average RNFL thickness (RE, p=0.016; LE, p=0.029). This difference was caused by the thinner RNFL in children with previous severe ROP (stages 3 and 4). Within the preterm group, the average RNFL thickness increased with larger BW (RE, p=0.050; LE, p=0.028), but there was no correlation with gestational age at birth. Conclusion The RNFL was reduced in prematurely-born children with severe ROP when compared to children born at term. It is hypothesised that severe retinopathy as well as ablation of the retina with laser treatment or cryotherapy may affect the axons of the ganglion cells and thus reduce RNFL thickness. Prematurely-born children with low BW had a thinner RNFL, suggesting a negative effect of low birth weight on neural development.

Place, publisher, year, edition, pages
2012. Vol. 96, no 7, 956-960 p.
National Category
URN: urn:nbn:se:uu:diva-177561DOI: 10.1136/bjophthalmol-2011-301010ISI: 000305579000008OAI: oai:DiVA.org:uu-177561DiVA: diva2:541285
Available from: 2012-07-16 Created: 2012-07-16 Last updated: 2015-07-07Bibliographically approved
In thesis
1. Retinal morphology and function in prematurely-born children at school age
Open this publication in new window or tab >>Retinal morphology and function in prematurely-born children at school age
2015 (English)Doctoral thesis, comprehensive summary (Other academic)
Abstract [en]

Preterm birth may lead to complications during the neonatal period that can cause visual dysfunctions. Retinopathy of prematurity (ROP) and neurological complications are well known reasons for visual dysfunctions, but preterm children with no or only mild ROP and no evident neurological problems may also be affected visually when they grow up. Retinal development starts early after gestation and continues long after birth. Major processes are underway during the second half of pregnancy when preterm children are born, and a preterm birth could possibly have a negative effect on normal retinal development.

The aims of the studies were to evaluate retinal morphology and function in former preterm children and compare the results with children born at term.

Former preterm children aged 5 to 17 years and born in a gestational age (GA) of 32 weeks or less were included in the different study groups. Children of similar ages who were born at term and with normal visual acuity (VA) acted as controls. Best corrected VA and refraction in cycloplegia were assessed in all children. Macular thickness and retinal nerve fiber layer (RNFL) thickness were measured with optical coherent tomography (OCT). Total retinal function was assessed with fullfield electroretinography (ffERG) and central macular function was assessed with multifocal electroretinography (mfERG).

Preterm children had thicker central maculae than controls. There was a positive correlation between central macular thickness and GA at birth. RNFL thickness was reduced in the preterm children with severe ROP and treated ROP, but children with mild or no ROP did not differ from the fullterm children. The photoreceptor function measured with ffERG and the macular function measured with mfERG were reduced in the preterm group compared to controls.

Preterm birth affects the retina both morphologically and functionally, and ROP has been suggested to be a reason for retinal changes. However, the results of this thesis indicate that children with no ROP also have retinal changes, suggesting an effect of prematurity itself. There were no correlations between any retinal changes and VA, but it is possible that larger studies using improved techniques may elucidate this further.

Place, publisher, year, edition, pages
Uppsala: Acta Universitatis Upsaliensis, 2015. 42 p.
Digital Comprehensive Summaries of Uppsala Dissertations from the Faculty of Medicine, ISSN 1651-6206 ; 1088
Retinopathy of prematurity, Prematurity, Retinal development, OCT, Fullfield ERG, Multifocal ERG
National Category
Medical and Health Sciences
Research subject
urn:nbn:se:uu:diva-247946 (URN)978-91-554-9214-4 (ISBN)
Public defence
2015-05-23, Gunnesalen, Ing. 10 Akademiska sjukhuset, Uppsala, 09:00 (English)
Available from: 2015-04-28 Created: 2015-03-25 Last updated: 2015-07-07

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