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.

中文翻译：

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绝经后 36 周龄早产儿全身健康与视网膜神经纤维层厚度之间的关联

背景/目的 系统性疾病引起的新生儿损伤与早产儿神经发育受损的途径有关。我们旨在调查全身健康因素与早产儿视网膜神经纤维层 (RNFL) 厚度之间的关联。方法 我们前瞻性地招募了婴儿，并在 Duke 重症监护室的床边使用手持式光学相干断层扫描系统对月经后 36 ± 1 周 (PMA) 的双眼进行了成像。我们使用单变量和多变量回归模型评估了 RNFL 厚度与 29 种全身健康因素之间的关联。结果 83 名具有 RNFL 厚度测量值的婴儿被纳入本研究。基于多变量模型，RNFL 厚度与成像时婴儿体重呈正相关，与败血症/坏死性小肠结肠炎 (NEC) 呈负相关。在单变量分析中，患有脓毒症/NEC 的婴儿的 RNFL 厚度比没有脓毒症/NEC 的婴儿低 10.4 µm（95% CI -15.9 至 -4.9）（p<0.001）。在对各种组合的混杂变量（出生体重、出生体重百分位数、胎龄、婴儿成像体重和生长速度）进行调整后，这种差异仍然具有统计学意义。在单变量分析中，成像时婴儿体重增加 250 g 与 RNFL 厚度增加 3.1 µm（95% CI 2.1 至 4.2）有关 (p<0.001)。结论 低婴儿体重和败血症/NEC 与 36 周 PMA 早产儿较薄的 RNFL 独立相关。据我们所知，这项研究首次表明脓毒症/NEC 可能影响视网膜神经发育。需要未来的纵向研究来进一步调查这种关系。可应合理要求提供数据。我们研究中的原始数据可在发送给相应作者的合理请求下获得。