title: Thinner Retinal Nerve Fiber Layer in Very Preterm Versus Term Infants and Relationship to Brain Anatomy and Neurodevelopment.
abstract: OBJECTIVE
  To assess retinal nerve fiber layer (RNFL) thickness at term-equivalent age in very preterm (<32 weeks gestational age) vs term-born infant cohorts, and compare very preterm infant RNFL thickness with brain anatomy and neurodevelopment.
  
  
  METHODS
  Cohort study.
  
  
  METHODS
  RNFL was semi-automatically segmented (1 eye per infant) in 57 very preterm and 50 term infants with adequate images from bedside portable, handheld spectral-domain optical coherence tomography imaging at 37-42 weeks postmenstrual age. Mean RNFL thickness was calculated for the papillomacular bundle (-15 degrees to +15 degrees) and temporal quadrant (-45 degrees to +45 degrees) relative to the fovea-optic nerve axis. Brain magnetic resonance imaging (MRI) scans clinically obtained in 26 very preterm infants were scored for global structural abnormalities by an expert masked to data except for age. Cognitive, language, and motor skills were assessed in 33 of the very preterm infants at 18-24 months corrected age.
  
  
  RESULTS
  RNFL was thinner for very preterm vs term infants at the papillomacular bundle ([mean ± standard deviation] 61 ± 17 vs 72 ± 13 μm, P < .001) and temporal quadrant (72 ± 21 vs 82 ± 16 μm, P = .005). In very preterm infants, thinner papillomacular bundle RNFL correlated with higher global brain MRI lesion burden index (R(2) = 0.35, P = .001) and lower cognitive (R(2) = 0.18, P = .01) and motor (R(2) = 0.17, P = .02) scores. Relationships were similar for temporal quadrant.
  
  
  CONCLUSIONS
  Thinner RNFL in very preterm infants relative to term-born infants may relate to brain structure and neurodevelopment.
authors.affiliation: Department of Ophthalmology, Duke University School of Medicine, Durham, North Carolina.
authors.forename: Adam L
authors.initials: AL
authors.lastname: Rothman
authors.affiliation: Department of Ophthalmology, Duke University School of Medicine, Durham, North Carolina.
authors.forename: Monica B
authors.initials: MB
authors.lastname: Sevilla
authors.affiliation: Department of Ophthalmology, Duke University School of Medicine, Durham, North Carolina.
authors.forename: Shwetha
authors.initials: S
authors.lastname: Mangalesh
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: Laura
authors.initials: L
authors.lastname: Edwards
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: Mallinckrodt Institute of Radiology, Washington University School of Medicine, St. Louis, Missouri.
authors.forename: Joshua S
authors.initials: JS
authors.lastname: Shimony
authors.affiliation: Department of Pediatrics, Duke University School of Medicine, Durham, North Carolina.
authors.forename: Carolyn E
authors.initials: CE
authors.lastname: Pizoli
authors.affiliation: Department of Ophthalmology, Duke University School of Medicine, Durham, North Carolina; Department of Pediatrics, Duke University School of Medicine, Durham, North Carolina.
authors.forename: Mays A
authors.initials: MA
authors.lastname: El-Dairi
authors.affiliation: Department of Ophthalmology, Duke University School of Medicine, 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 School of Medicine, Durham, North Carolina; Department of Biomedical Engineering, Pratt School of 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: D003430:Cross-Sectional Studies; D005260:Female; D005500:Follow-Up Studies; D005865:Gestational Age; D006801:Humans; D062071:Infant, Extremely Premature; D007231:Infant, Newborn; D007235:Infant, Premature, Diseases / Q000175:diagnosis*; D008279:Magnetic Resonance Imaging; D008297:Male; D009412:Nerve Fibers / Q000473:pathology*; D011446:Prospective Studies; D012165:Retinal Ganglion Cells / Q000473:pathology*; D012720:Severity of Illness Index; D047929:Term Birth; D041623:Tomography, Optical Coherence / Q000379:methods*