title: Poorer neurodevelopmental outcomes associated with cystoid macular edema identified in preterm infants in the intensive care nursery.
abstract: OBJECTIVE
  To evaluate the association between cystoid macular edema (CME) observed in very preterm infants and developmental outcomes at 18 to 24 months corrected age.
  
  
  METHODS
  Cohort study.
  
  
  METHODS
  Infants born at or less than 1500 g or at or less than 30 weeks postmenstrual age who underwent screening for retinopathy of prematurity (ROP) in an intensive care nursery.
  
  
  METHODS
  Bedside handheld spectral-domain optical coherence tomography (SD OCT; Envisu, Bioptigen, Inc, Research Triangle Park, NC) imaging was obtained from preterm infants who were being screened for ROP and graded for presence of CME, central foveal thickness (CFT), inner nuclear layer thickness, and foveal-to-parafoveal thickness ratio. At 18 to 24 months corrected age, the children were assessed with the Bayley Scales of Infant and Toddler Development, Third Edition.
  
  
  METHODS
  Scores on the Bayley cognitive, language, and motor subscales.
  
  
  RESULTS
  Among 77 children with SD OCT imaging, 53 were evaluated with the Bayley Scales. Compared with children who did not have CME as infants (n=22), the mean score for children who had CME (n=31) was 7.3 points (95% confidence interval [CI], -15.5 to 0.9; P=0.08) lower on the cognitive subscale, 14.1 points (95% CI, -22.7 to -5.5; P=0.002) lower for the language subscale, and 11.5 points (95% CI, -21.6 to -1.3; P=0.03) lower for the motor subscale. Differences were maintained after adjusting for gestational age and birth weight. Severity of CME, as assessed by foveal-to-parafoveal thickness ratio, within the CME group correlated with poorer cognitive (R2=0.16, P=0.03) and motor (R2=0.15, P=0.03) development.
  
  
  CONCLUSIONS
  Cystoid macular edema observed on SD OCT in very preterm infants screened for ROP is associated with poorer language and motor skills at 18 to 24 months corrected age. Evaluation of the retina with SD-OCT may serve as an indicator of neurodevelopmental health for very preterm infants in the intensive care nursery.
authors.affiliation: Department of Ophthalmology, Duke University Eye Center, Erwin Rd, Durham, North Carolina.
authors.forename: Adam L
authors.initials: AL
authors.lastname: Rothman
authors.affiliation: Department of Ophthalmology, Duke University Eye Center, Erwin Rd, Durham, North Carolina.
authors.forename: Du
authors.initials: D
authors.lastname: Tran-Viet
authors.affiliation: Department of Pediatrics, Duke University School of Medicine, Durham, North Carolina.
authors.forename: Kathryn E
authors.initials: KE
authors.lastname: Gustafson
authors.affiliation: Department of Pediatrics, Duke University School of Medicine, Durham, North Carolina.
authors.forename: Ricki F
authors.initials: RF
authors.lastname: Goldstein
authors.affiliation: Department of Ophthalmology, University of Pennsylvania School of Medicine, Philadelphia, Pennsylvania.
authors.forename: Maureen G
authors.initials: MG
authors.lastname: Maguire
authors.affiliation: Department of Ophthalmology, Duke University Eye Center, Erwin Rd, Durham, North Carolina.
authors.forename: Vincent
authors.initials: V
authors.lastname: Tai
authors.affiliation: Department of Ophthalmology, Duke University Eye Center, Erwin Rd, Durham, North Carolina.
authors.forename: Neeru
authors.initials: N
authors.lastname: Sarin
authors.affiliation: Department of Ophthalmology, Duke University Eye Center, Erwin Rd, Durham, North Carolina.
authors.forename: Amy Y
authors.initials: AY
authors.lastname: Tong
authors.affiliation: Department of Ophthalmology, University of Pennsylvania School of Medicine, Philadelphia, Pennsylvania.
authors.forename: Jiayan
authors.initials: J
authors.lastname: Huang
authors.affiliation: Department of Pediatrics, Duke University School of Medicine, Durham, North Carolina.
authors.forename: Laura
authors.initials: L
authors.lastname: Kupper
authors.affiliation: Department of Pediatrics, Duke University School of Medicine, Durham, North Carolina.
authors.forename: C Michael
authors.initials: CM
authors.lastname: Cotten
authors.affiliation: Department of Ophthalmology, Duke University Eye Center, Erwin Rd, Durham, North Carolina; Department of Pediatrics, Duke University School of Medicine, Durham, North Carolina.
authors.forename: Sharon F
authors.initials: SF
authors.lastname: Freedman
authors.affiliation: Department of Ophthalmology, Duke University Eye Center, Erwin Rd, Durham, North Carolina; Department of Biomedical Engineering, Duke University, Durham, North Carolina. Electronic address: cynthia.toth@dm.duke.edu.
authors.forename: Cynthia A
authors.initials: CA
authors.lastname: Toth
mesh_terms: D002657:Child Development; D015331:Cohort Studies; D002658:Developmental Disabilities / Q000175:diagnosis*; D005260:Female; D005865:Gestational Age; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D019102:Infant, Very Low Birth Weight; D007363:Intensive Care Units, Neonatal; D008269:Macular Edema / Q000175:diagnosis*; D008297:Male; D015997:Neonatal Screening; D011446:Prospective Studies; D011581:Psychological Tests; D011596:Psychomotor Disorders / Q000175:diagnosis*; D012178:Retinopathy of Prematurity / Q000175:diagnosis*; D041623:Tomography, Optical Coherence