Evaluation of optic nerve development in preterm and term infants using handheld spectral-domain optical coherence tomography

Amy Y. Tong, Mays El-Dairi, Ramiro S. Maldonado, Adam L. Rothman, Eric L. Yuan, Sandra S. Stinnett, Laura Kupper, C. Michael Cotten, Kathryn E. Gustafson, Ricki F. Goldstein, Sharon F. Freedman, Cynthia A. Toth

Research output: Contribution to journalArticlepeer-review

35 Scopus citations

Abstract

Purpose To evaluate effects of prematurity on early optic nerve (ON) development and the usefulness of ON parameters as indicators of central nervous system (CNS) development and pathology. Design Prospective, cross-sectional, longitudinal study. Participants Forty-four preterm infants undergoing retinopathy of prematurity (ROP) screening and 52 term infants. Methods We analyzed ON from portable handheld spectral-domain optical coherence tomography (SD-OCT) images (Bioptigen, Inc, Research Triangle Park, NC) of 44 preterm and 52 term infants. The highest-quality ON scan from either eye was selected for quantitative analysis. Longitudinal analysis was performed at 31-36 weeks and 37-42 weeks postmenstrual age (PMA). Preterm ON parameters also were assessed for correlation with indicators of cognitive, language, and motor development and CNS pathology. Main Outcome Measures Vertical cup diameter (vCD), vertical disc diameter (vDD), vertical cup-to-disc ratio (vCDR), cup depth, and indicators of neurocognitive development and CNS pathology. Results At 37-42 weeks PMA, preterm infants had larger vCD and vCDR than term infants (908 vs. 700 μm [P<0.001] and 0.68 vs. 0.53 μm [P<0.001], respectively), whereas cup depth and vDD were not significantly different. Longitudinal changes (n = 26 preterm eyes; mean interval, 4.7 weeks) in vDD and in vCDR were an increase of 74 μm (P = 0.008) and decrease of 0.05 (P = 0.015), respectively. In preterm infants (n = 44), periventricular leukomalacia was associated with larger vCD (1084 vs. 828 μm; P = 0.005) and vCDR (0.85 vs. 0.63; P<0.001), posthemorrhagic hydrocephalus was associated with shallower cup (331 vs. 456 μm; P = 0.030), and clinical magnetic resonance imaging was associated with larger vCDR (0.73 vs. 0.64; P = 0.023). In 23 preterm infants with Bayley Scales of Infant Development scores, larger vCDR was associated with lower cognitive scores (P = 0.049). Conclusions This is the first analysis of ON parameters in premature infants using SD-OCT. It demonstrated that by age of term birth, vCD and vCDR are larger in preterm infants who were screened for ROP than in term infants. In this prospective pilot study, ON parameters in these preterm infants associate weakly with CNS pathology and future cognitive development. Future prospective studies with larger numbers are necessary before further conclusions can be made.

Original languageEnglish (US)
Pages (from-to)1818-1826
Number of pages9
JournalOphthalmology
Volume121
Issue number9
DOIs
StatePublished - Sep 2014
Externally publishedYes

Keywords

  • Abbreviations and Acronyms
  • central nervous system
  • CI
  • CNS
  • confidence interval
  • ICC
  • intraclass correlation coefficients
  • magnetic resonance imaging
  • MRI
  • neonatal intensive care unit
  • NICU
  • OCT
  • ON
  • optic nerve
  • optical coherence tomography
  • periventricular leukomalacia
  • PMA
  • postmenstrual age
  • PVL
  • retinal nerve fiber layer
  • retinopathy of prematurity
  • RNFL
  • ROP
  • SD
  • spectral-domain
  • vCD
  • vCDR
  • vDD
  • vertical cup diameter
  • vertical cup-to-disc ratio
  • vertical disc diameter

ASJC Scopus subject areas

  • Ophthalmology

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