Foveal Differentiation and Inner Retinal Displacement Are Arrested in Extremely Premature Infants.

Journal Article (Journal Article)

PURPOSE: Children with a history of prematurity often have poorly developed foveae but when during development foveal differences arise. We hypothesize that the course of foveal development is altered from the time of preterm birth. METHODS: Eyes of 102 preterm infants undergoing retinopathy of prematurity screening examinations in the STudy of Eye imaging in Premature infantS (BabySTEPS) (NCT02887157) were serially imaged between 30 and 42 weeks postmenstrual age (PMA) using handheld optical coherence tomography systems. Total retinal thickness, inner retinal layer (IRL) thickness, and outer retinal layer (ORL) thickness were measured at the foveal center and parafovea. Foveal put depth, IRL thickness, and ORL thickness were compared between infants born at different gestational ages using mixed effects models. RESULTS: Foveal pit depth and IRL thickness were inversely related to gestational age; on average, the most premature infants had the thickest IRL and shallowest pits at all PMAs. Differences were evident by 30 weeks PMA and persisted through 42 weeks PMA. The foveal pits of the most premature infants did not progressively deepen, and the IRLs did not continue to thin with increasing chronological age. CONCLUSIONS: Foveation in extremely preterm infants is arrested from the earliest observed ages and fails to progress through term equivalent age. The developmental displacement of the IRL from the foveal center into the parafovea does not occur normally after preterm birth. These observations suggest that foveal hypoplasia seen in children with history of prematurity is due to disturbances in foveal development that manifest within weeks of birth.

Full Text

Duke Authors

Cited Authors

  • O'Sullivan, ML; Ying, G-S; Mangalesh, S; Tai, V; Divecha, HR; Winter, KP; Toth, CA; Chen, X; BabySTEPS Group,

Published Date

  • February 1, 2021

Published In

Volume / Issue

  • 62 / 2

Start / End Page

  • 25 -

PubMed ID

  • 33599735

Pubmed Central ID

  • PMC7900865

Electronic International Standard Serial Number (EISSN)

  • 1552-5783

Digital Object Identifier (DOI)

  • 10.1167/iovs.62.2.25


  • eng

Conference Location

  • United States