OCULAR FUNDUS MORPHOLOGY IN PRETERM CHILDREN - INFLUENCE OF GESTATIONAL-AGE, BIRTH SIZE, PERINATAL MORBIDITY, AND POSTNATAL-GROWTH

Purpose. To determine the influence of gestational age, birth size, pe rinatal morbidity, and postnatal growth on fundus morphology in preter m children using digital image analysis of fundus photographs. Methods . Thirty-nine preterm children (mean postmenstrual gestational age, 29 .1 weeks; range, 24.6 to 32) were included in the study. Thirty-nine h ealthy children, born at term, were used as control subjects. Fundus p hotographs were obtained at a mean age of 4.8 years (preterm) and 6.1 years (control subjects).Results. There was no difference in optic dis c, excavation, or peripapillary crescent area between the two groups. In the group of preterm children, a large optic disc size was associat ed with a low birth weight (r(s)=-0.29, P=0.07), duration of assisted ventilation (r(s)=0.43, P=0.006), and number of blood transfusions (r( s)=0.33, P=0.04). The girls born prematurely showed a negative relatio n between the length of gestation and the area of the optic disc (r(2) =0.28, P=0.009). No such relation was found in bays. The preterm child ren had increased tortuosity of retinal vessels (P<0.001 and P<0.002 f or arteries and veins, respectively) and reduced number of vascular br anching points (P<0.001) compared with those of the control subjects. There were no associations between these vascular abnormalities and th e perinatal and postnatal variables studied. Conclusions. No differenc e in optic disc morphology between preterm children and control subjec ts was found. However, preterm birth seems to affect the retinal vascu lar pattern close to the optic disc, independently of retinopathy of p rematurity. Among the girls born preterm, optic disc size was negative ly correlated to gestational age.