OBJECTIVE: To assess an influence of perinatal characteristics on morphology and retinal vascularity of the macula in preterm children.
METHODS: A cohort of 123 preterm children at the age of 10.5 years (IQR: 8.12-12.77) was prospectively assessed. Optical coherence tomography angiography (OCTA) was performed using RTVueXR Avanti. Foveal thickness, parafoveal thickness, size of foveal avascular zone (FAZ), superficial and deep vessel density, central choroidal thickness (CCT) were analyzed. The associations between OCTA results and perinatal factors, including the presence of ROP and therapy requirements were assessed in preterm children.
RESULTS: Significantly smaller FAZ, higher foveal thickness and vessel density were noted in children with ROP, Respiratory Distress Syndrome, Bronchopulmonary Dysplasia, required erythropoietin, transfusion or steroids. Foveal thickness was increased in children with ROP (p < 0.001) and following laser treatment (p < 0.05). Thinner CCT was noted in children with a history of sepsis (p < 0.05) and ROP required treatment (p < 0.05). Pregnancy bleeding was associated with higher superficial foveal vessel density (p < 0.05) and smaller FAZ (p < 0.05).
CONCLUSIONS: Neonatal factors have a huge impact on retinal development, but the role of prenatal factors should not be neglected in preterm children.
目的:评估围产期特征对早产儿黄斑形态和视网膜血管的影响。
方法:前瞻性评估了123名10.5岁的早产儿(IQR:8.12-12.77)。使用RTVueXRAvanti进行光学相干断层扫描血管造影(OCTA)。中心凹厚度,旁凹厚度,中央凹无血管区(FAZ)的大小,浅血管和深血管密度,对中央脉络膜厚度(CCT)进行分析。OCTA结果与围产期因素之间的关联,在早产儿中评估了ROP的存在和治疗要求.
结果:FAZ明显变小,ROP患儿的中央凹厚度和血管密度较高,呼吸窘迫综合征,支气管肺发育不良,需要促红细胞生成素,输血或类固醇。ROP患儿(p<0.001)和激光治疗后(p<0.05)的中心凹厚度增加。有脓毒症病史的儿童CCT较低(p<0.05),ROP需要治疗(p<0.05)。妊娠出血与较高的浅凹血管密度(p<0.05)和较小的FAZ(p<0.05)相关。
结论:新生儿因素对视网膜发育有巨大影响,但产前因素在早产儿中的作用不容忽视。