Purpose

To quantify inner and outer retinal layer thicknesses and understand their relevance to visual function among young adults born extremely preterm (EP).

Design

Prospective observational study with 19 years of follow-up.

Participants

A total of 354 eyes (226 eyes of former EP infants and 128 age-matched full-term control eyes) from 177 young adults were evaluated. Among EP participants, 50% of eyes (112/226) were not previously diagnosed with neonatal retinopathy of prematurity (ROP), 38% of eyes (84) had ROP not deemed to require treatment in the neonatal period, and 13% of eyes (30) had neonatal cryotherapy or laser ablation for ROP.

Methods

Subjects underwent eye examinations including best-corrected visual acuity (BCVA) and Heidelberg Spectralis (Heidelberg Engineering, Heidelberg, Germany) macular spectral-domain (SD) OCT imaging. Retinal layers were auto-segmented and thickness profiles were computed at the fovea by the instrument software.

Main Outcome Measures

Correlation between retinal sublayer thickness and BCVA.

Results

Compared with control eyes, the inner and outer retinal layers of EP eyes were significantly thicker and BCVA was significantly reduced. Retinal layer thicknesses and BCVA were similar for untreated EP eyes and those without neonatal ROP. In contrast, treated eyes had increased inner and outer retinal layer thickness and decreased vision. Inner retinal layer thickness was moderately correlated with worse BCVA (r = 0.30, P < 0.001), but outer retinal layer thickness was not (r = −0.01, P = 0.80). Multivariate regression indicated ganglion cell layer thickness was a significant independent predictor of BCVA.

Conclusions

Extremely premature birth influences maturation of the fovea and visual outcomes into early adult life. Increased ganglion cell layer thickness was associated with worse BCVA. Eyes requiring neonatal treatment for ROP had associated worse BCVA at the age of 19 years.

中文翻译：

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极早产年轻人视网膜厚度分布与视觉结果的关系

目的

量化视网膜内外层厚度，并了解其与极早产 (EP) 出生的年轻人的视觉功能的相关性。

设计

前瞻性观察研究，随访 19 年。

参与者

评估了来自 177 名年轻人的总共 354 只眼睛（前 EP 婴儿的 226 只眼睛和 128 只年龄匹配的足月对照眼睛）。在 EP 参与者中，50% 的眼睛 (112/226) 之前没有被诊断出患有新生儿早产儿视网膜病变 (ROP)，38% 的眼睛 (84) 的 ROP 在新生儿期不需要治疗，13% 的眼睛(30) 接受新生儿冷冻治疗或激光消融治疗 ROP。

方法

受试者接受了眼科检查，包括最佳矫正视力 (BCVA) 和 Heidelberg Spectralis (Heidelberg Engineering, Heidelberg, Germany) 黄斑光谱域 (SD) OCT 成像。视网膜层被自动分割，并通过仪器软件在中央凹处计算厚度分布。

主要观察指标

视网膜亚层厚度与 BCVA 之间的相关性。

结果

与对照眼相比，EP眼的视网膜内外层明显增厚，BCVA明显降低。未经治疗的 EP 眼和没有新生儿 ROP 的眼的视网膜层厚度和 BCVA 相似。相比之下，接受治疗的眼睛的视网膜内外层厚度增加，视力下降。视网膜内层厚度与较差的 BCVA 呈中度相关（r  = 0.30，P < 0.001），但视网膜外层厚度则不相关（r  = -0.01，P  = 0.80）。多元回归表明神经节细胞层厚度是 BCVA 的重要独立预测因子。

结论

极度早产会影响中央凹的成熟和成年早期的视觉结果。增加的神经节细胞层厚度与较差的 BCVA 相关。需要新生儿治疗 ROP 的眼睛在 19 岁时与较差的 BCVA 相关。