Macular Thickness Differences Noted Among Children Born Preterm

Children who are born very preterm (younger than 32 weeks gestational age) exhibit variations in macular thickness compared with those who are born at full term upon reaching school age (5-8 years), according to research published in the Journal of the American Association for Pediatric Ophthalmology and  Strabismus. These differences include a thicker central macula, surrounded by a thinner inner ring, which is surrounded by a thicker outer ring, according to the report.  

Researchers conducted the cross-sectional study at a single center and included children aged 5-8 years who were born preterm (n=106; 52% boys) and control individuals (n=49; 57% boys) who were born at full term. Participants underwent optical coherence tomography (OCT) imaging and the investigators compared macular thickness profiles and symmetry between the 2 cohorts. A total of 19% of children who were born preterm had retinopathy of prematurity. 

Stratified by gestational age at birth, the greatest difference in thickness was observed in the fovea among children born at 24 to 25 weeks gestational age compared with children in the control group (254.7 vs 193.2 µm; P <.001). The children born at 24 to 25 weeks gestation also exhibited thinner inner (267.0 vs 305.4 µm; P <.001) and thicker outer (305.5 vs 271.0 μm; P <.001) ring area thicknesses compared with the children born at full term. No significant differences in inner and outer ring thickness were observed according to the degree of prematurity.

Among the preterm cohort, the intraclass correlations in interocular thickness between right and left eyes were significant (all r >0.7; P <.01). When eyes were stratified according to absolute interocular difference in spherical equivalent refractive area (<0.5 diopters [D]; n=89 and ≥0.5 D; n=17), significant group differences were observed in the parafoveal regions located immediately lateral to fovea (A3, P =.04 and A5, P =.0002) and in 1 region of the paramacular area (A7, P =.00003).

“Many organs in premature infants, including the eyes, may be subject to disorders that lead to impairment,” according to the researchers. “Study of macular thickness in preterm children can help elucidate the pathophysiological mechanisms involved in macular function and the macular remodeling that can occur during this period of development.”

Study limitations include a limited study sample and the selection of participants based on OCT image quality.