Hanna Åkerblom

Central macular thickness is correlated with gestational age at birth in prematurely born children

Background/aim Previous studies have revealed various subnormal visual functions in prematurely born children. The present study aimed to determine the retinal macular thickness in prematurely born children and compare with children born at term. Methods The eyes of 65 prematurely born children aged 5–16 years were examined with Stratus optical coherence tomography (OCT) 3, and the results were compared with those of 55 children born at term. The retinal macular thickness in the nine EDTRS macular areas (A1–A9), the foveal minimum and the total macular volume were determined. Results The central macular thickness (A1 and foveal minimum) was significantly thicker in the prematurely born children than in those born at term. There was no correlation between macular thickness and visual acuity or refraction. Children with previous retinopathy of prematurity (ROP) had significantly thicker central maculae than those without it. Prematurely born children without previous ROP had significantly thicker central maculae than the control group. Multiple regression analyses showed that gestational age at birth was the only risk factor for a thick central macula. Conclusion Prematurely born children had thicker central maculae than those born at term. Regardless of ROP, the degree of prematurity was the most important risk factor for abnormal foveal development.

Time to consider a new treatment protocol for aggressive posterior retinopathy of prematurity

Purpose:  To discuss treatment modalities for aggressive posterior retinopathy of prematurity (AP‐ROP).

Retinal nerve fibre layer thickness in school-aged prematurely-born children compared to children born at term.

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.

Reduction of Rod and Cone Function in 6.5-Year-Old Children Born Extremely Preterm

Importance The function of rods and cones in children born extremely preterm has not yet been fully investigated. Objective To compare retinal function via full-field electroretinographic (ffERG) recordings in 6.5-year-old children born extremely preterm with children born at term. Design, Setting, and Participants A subcohort study was conducted from July 1, 2010, to January 15, 2014, of the national Extremely Preterm Infants in Sweden Study, including preterm children (<27 weeks’ gestational age) and children born at term, at 6.5 years of age and living in the Uppsala health care region in Sweden. Full-field electroretinography was performed binocularly, using DTL electrodes and electroretinographic (ERG) protocols with flash strengths of 0.009, 0.17, 3.0, and 12.0 candelas (cd)/s/m2, together with 30-Hz flicker and 3.0 cd/s/m2 single-cone flash. Main Outcomes and Measures The ffERG recordings were analyzed, and their associations with gestational age and retinopathy of prematurity were examined. Results Adequate ffERG recordings were obtained from 52 preterm children (19 girls and 33 boys; mean [SD] age at examination, 6.6 [0.1] years) and 45 children born at term (22 girls and 23 boys; mean [SD] age at examination, 6.6 [0.1] years). Lower amplitudes of the combined rod and cone responses (the a-wave of the dark-adapted ERG protocol of 3.0 cd/s/m2: mean difference, –48.9 &mgr;V [95% CI, –80.0 to –17.9 &mgr;V]; P=.003; the a-wave of the dark-adapted ERG protocol of 12.0 cd/s/m2: mean difference, –55.7 &mgr;V [95% CI, –92.5 to –18.8 &mgr;V]; P = .004), as well as of the isolated cone response (30-Hz flicker ERG: mean difference, –12.1 &mgr;V [95% CI, –22.5 to –1.6 &mgr;V]; P = .03), were found in the preterm group in comparison with the group born at term. The implicit time of the combined rod and cone responses (the a-wave of the dark-adapted ERG protocol of 12.0 cd/s/m2) was longer (mean difference, 1.2 milliseconds [95% CI, 0.3-2.0 milliseconds]; P = .01) in the preterm group, as were the isolated cone responses (30-Hz flicker ERG: mean difference, 1.2 milliseconds [95% CI, 0.5-1.8 milliseconds]; P < .001), than in the group born at term. No association was found between the ffERG recordings and gestational age or retinopathy of prematurity in the preterm group. Conclusions and Relevance Both rod function and cone function were reduced in children born extremely preterm when compared with children born at term. There was no association with retinopathy of prematurity in the preterm group, which suggests that being born extremely preterm may be one of the main reasons for a general retinal dysfunction.

'Congenital' nystagmus may hide various ophthalmic diagnoses.

To investigate whether patients registered at a low‐vision centre with ‘nystagmus’ had any underlying, but so far unknown, ophthalmic diagnosis.

The rim area of the optic nerve head, assessed with Heidelberg retina tomography, is smaller in prematurely born children than in children born at term

To examine the optic nerve head with Heidelberg tomography (HRT) in prematurely born school‐age children and compare them to children born at term.