Children Born Prematurely Have Higher Risk of Foveal Hypoplasia

Baby in ICU
UNDATED PHOTO: At Bascolm Palmer Hospital, Dr. Steve Christiansen performs an ROP (Retinopathy of Prematurity) exam on a premature ICU baby 1992 in Miami, Florida. Premies are at high risk for retinal problems.It is widely believed that sight is the most complex of the five senses. It is also often thought to be our most valued, so much so that scientists are engaged in a constant endeavor to fully understand sight so that they may better fight the seemingly endless battle against blindness. (Photo by Joe McNally/Getty Images)
Foveal thickness significantly differs among foveal gradings and races. However, foveal gradings cannot predict visual acuity.

This article is part of Optometry Advisor’s conference coverage from the 2021 meeting of the American Academy of Optometry, held in Boston from November 3 to 6, 2021. The team at Optometry Advisor will be reporting on a variety of the research presented by the primary eye care experts at the AAO. Check back for more from the AAO Optometry 2021 Meeting..

Children born prematurely had higher risk of foveal hypoplasia, researchers found in a study they presented at the American Academy of Optometry 2021 meeting held in Boston November 3-6.1

The researchers had found in a previous study that mean total foveal thickness was significantly higher among those at risk of retinopathy of prematurity (ROP), and that foveal thickness decreased with increased gestational age.2 Children who are Black had thinner foveae compared with children who are White. Girls had significantly thinner fovea compared with boys. The investigators continued analyzing foveal anatomy in this population in the current study by examining foveal thickness.1

Children (n=91) born before 32 weeks of gestation who were at risk of ROP and a control group of 68 children born full-term participated in the study. All children were between 4 to 18 years of age.1

Foveal structure within 1 mm and 3 mm early treatment diabetic retinopathy study (ETDRS) circular grid was measured with spectral-domain optical coherence tomography (SD-OCT) imaging and graded with Leicester Grading System for foveal hypoplasia. Grading correlated to total foveal thickness and visual acuity at testing day.

Mean total foveal thickness in the children born preterm was 285±26 mm, significantly higher compared with the control group (263±20 µm) (T=-6.09 P <.05).

Fifty-nine of the children born preterm had foveal hypoplasia (27 Grade 1a, 24 Grade 1b, 5 Grade 2, 3 Grade 3). Grade 1b, 2, and 3 were significantly thicker compared with Grade 0 (P <.01). The researchers found that foveal thickness was significantly different among grading (F=9.17 P <.001).

Participants who were White had significantly thicker foveal thickness compared with participants who were Black (F=11.97, P <.001). Differences in visual acuity among gradings and race were not statistically significant.

About two-thirds of the group of premature patients included in the study had foveal hypoplasia, the researchers reported.

“The fovea was significantly thicker in the ROP-risk group than the control group,” the investigators said. “Foveal thickness significantly differs among foveal gradings and races. However, foveal gradings cannot predict visual acuity.”

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1. Wang J, Hendricks D, Lehmen S, et al. Foveal structure grading and foveal hypoplasia in children born preterm. Presented at: American Academy of Ophthalmology 2021 Annual Meeting; November 12-15, 2021. Abstract Board #182 215379.

2. Jin J, Friess A, Hendricks D, et al. Effect of gestational age at birth, sex, and race on foveal structure in children. Graefes Arch Clin Exp Ophthalmol. 2021;259:3137–3148.  doi:10.1007/s00417-021-05191-3