Correlation of morphological parameters and visual acuity with neurological development in former preterm children aged 4-10 years

Acta Ophthalmol. 2018 Dec;96(8):e1010-e1017. doi: 10.1111/aos.13755. Epub 2018 Mar 9.

Abstract

Purpose: The objective of this study was to investigate the relationship between visual acuity, peripapillary retinal nerve fibre layer (pRNFL), retinal thickness at the fovea and other factors with the neurologic status of former preterm children.

Methods: In this cross-sectional hospital based study in a maximum care tertiary centre, detailed anthropometric and ophthalmological data of former preterm children ranging from 4 to 10 years of age with a gestational age (GA) ≤32 weeks were assessed. Analyses of the correlation between pRNFL and foveal thickness, as well as visual acuity (VA) parameters at 4-10 years of age, with neurological development were evaluated at 2 years of age by Bayley Scales II of Infant Development, including Psychomotor Developmental Index (PDI) and Mental Developmental Index (MDI).

Results: Data were available for 106 former preterm children. Univariate analysis revealed a correlation between PDI with pRNFL thickness (B = 0.43; p = 0.013), VA (B = -29.2; p < 0.001), GA (B = 2.7; p = 0.002), retinopathy of prematurity (ROP; B = -16.3; p < 0.001) and intraventricular haemorrhages (IVH; B = -22.9; p < 0.001) but not with strabismus or foveal thickness. In the multivariable analysis, the association remained for visual acuity and IVH, but not for pRNFL thickness or ROP. Mental Developmental Index (MDI) was associated with visual acuity (B = -34.3; p = 0.001), GA (B = 2.53; p = 0.02) and IVH (B = -15.4; p = 0.02), the latter also in the multivariable analysis.

Conclusion: This study revealed an association between PDI at 2 years of age and lower visual acuity later in childhood. However, there was no correlation between retinal morphology and neurologic outcome in former preterm children after adjusting for several potential confounders.

Keywords: Bayley Scales of Infant Development; birth weight; gestational age; neuronal development; prematurity; retinal nerve fibre layer.

MeSH terms

  • Child
  • Child, Preschool
  • Cross-Sectional Studies
  • Disease Progression
  • Female
  • Follow-Up Studies
  • Fovea Centralis / pathology*
  • Humans
  • Infant, Low Birth Weight
  • Male
  • Retinopathy of Prematurity / pathology*
  • Retinopathy of Prematurity / physiopathology
  • Retrospective Studies
  • Severity of Illness Index
  • Time Factors
  • Tomography, Optical Coherence / methods*
  • Visual Acuity*