Ocular fundus abnormalities in children born before 29 weeks of gestation:a population-based study

Purpose Preterm birth has been found to be associated with increased morbid ity of the central nervous and vascular tissues. To investigate the influen ce of preterm birth on the optic disc and retinal vessels, we examined the ocular fundus in school-aged children born very preterm. Methods A prospective, population-based study was performed in 50 very pret erm children (median age 7 years, range 5-9 years) with a median gestationa l age at birth of 27 weeks (range 24-28 weeks) and a median birth weight of 1055 g (range 450-1520 g). The ocular fundus was examined by ophthalmoscop y in 50 children, and the optic nerve and retinal vessel morphology was eva luated by digital image analysis of ocular fundus photographs in 45 of thes e children. Results The median optic disc area was significantly smaller (r = 0.0002) i n the preterm children compared with a reference group. There was no differ ence in cup area and, consequently, the rim area was significantly smaller ((p = 0.0002) in the preterm children. Children with early signs of brain l esions commonly had a rim area below the median of the reference group. Pre term children also commonly had an abnormal retinal vascular pattern that w as independent of a previous history of retinopathy of prematurity. Conclusion Very preterm birth was associated with subnormal optic disc and rim areas and an abnormal vascular pattern. The findings clearly demonstrat e the effect of preterm birth on the development of these structures. The l ong term clinical prognosis of these findings has yet to be determined.