Thickness analysis of the retinal nerve fiber layer, macula, and choroid in children born preterm stratified by birth weight.

Abstract

Objective: To determine whether birth weight influences retinal development in children born preterm, we analyzed the thickness of the retinal nerve fiber layer (RNFL), fovea centralis, and choroid.

Methods: Participants born preterm were categorized as extremely low birth weight (ELBW, <1000 g), very low birth weight (VLBW, 1000-1500 g), and low birth weight (LBW, 1500-2500 g). RNFL thickness, fovea centralis thickness (macular center), and subfoveal choroidal thickness were measured using optical coherence tomography. Linear regression was used to evaluate associations between OCT parameters and birth weight.

Results: Of the 54 preterm-born children included, 34 were diagnosed with retinopathy of prematurity (ROP) (stage 1: 7; stage 2: 19; stage 3: 7), with 5 receiving laser treatment. Inferior and global mean RNFL thicknesses were lower in the ROP cohort than in the non-ROP cohort (p = 0.0012 and p = 0.003, respectively). Fovea centralis thickness and choroidal thickness did not differ between the ROP and non-ROP cohorts (p = 0.16 and p = 0.97, respectively). In adjusted regression models, birth weight was associated with inferior RNFL thickness (β 0.09; 95% CI 0.01-0.11; p = 0.001), nasal RNFL thickness (β 0.06; 95% CI 0.01-0.10; p = 0.001), and fovea centralis thickness (β 0.04; 95% CI 0.01-0.08; p < 0.001).

Conclusion: In children born preterm, lower birth weight is associated with thinner inferior and nasal RNFL. OCT-derived RNFL measurements may help inform long-term monitoring of retinal development in preterm-born children, particularly those with low birth weight and/or ROP history.