The study on this page investigates macular changes in adults with a history of premature birth, focusing on macular structure and vascularity using ocular coherence tomography-angiography (OCT-A). Here are the main points:
1. Purpose: To characterize macular changes in premature-birth adults.
2. Methods: Retrospective review of adults with a history of premature birth without retinopathy of prematurity (ROP) treatment, compared to healthy controls.
3. Results:
- Vascular Changes:
- Decreased foveal avascular zone (FAZ) area.
- Decreased FAZ circularity index.
- Decreased vessel density in both superficial and deep capillary plexuses.
- Structural Changes:
- Shallower foveal pit depth.
- Decreased cube average thickness.
- Increased central subfield thickness-to-cube average thickness ratio.
4. Conclusion: Even without ROP treatment, premature birth is associated with multiple changes in macular structure and vascularity that persist into adulthood. These findings suggest that premature birth affects macular development, leading to alterations that can be detected using OCT-A.
Purpose
- The study aims to characterize changes in macular structure and vascularity in adults with a history of premature birth who did not require treatment for retinopathy of prematurity (ROP).
Methods
- Study Design: Retrospective review of adults with a history of premature birth and healthy controls.
- Participants: 34 eyes were included (17 eyes from 10 premature-birth adults, 17 eyes from 11 control patients).
- Imaging Techniques: Swept-source ocular coherence tomography-angiography (OCT-A) scans were analyzed for various macular parameters.
- Statistical Analysis: Univariate and multivariate linear regression analyses were performed.
Results
1. Vascular Changes:
- Foveal Avascular Zone (FAZ):
- Area: Significantly smaller in premature adults (0.11 ± 0.084 mm²) compared to controls (0.21 ± 0.079 mm²).
- Circularity Index: Lower in premature adults (0.46 ± 0.17) compared to controls (0.67 ± 0.11), indicating a less uniform FAZ shape.
- Perimeter Length: No significant difference between premature adults and controls.
- Vessel Density:
- Superficial Capillary Plexus (SCP): Decreased in premature adults (39 ± 8%) compared to controls (45 ± 3%).
- Deep Capillary Plexus (DCP): Decreased in premature adults (40 ± 6%) compared to controls (47 ± 4%).
2. Structural Changes:
- Foveal Pit Depth: Shallower in premature adults (89 ± 42 µm) compared to controls (140 ± 20 µm).
- Cube Average Thickness (CAT): Decreased in premature adults (270 ± 18 µm) compared to controls (286 ± 13 µm).
- Central Subfield Thickness (CST) to CAT Ratio: Increased in premature adults (1.05 ± 0.09) compared to controls (0.94 ± 0.07).
3. Correlation with Visual Acuity:
- Despite abnormal macular vasculature morphology, 8 out of 10 premature-birth adults had 20/40 vision or better.
- No significant correlation between visual acuity and various FAZ or vessel density metrics.
Conclusion
- Premature birth, even without the need for ROP treatment, is associated with persistent changes in macular structure and vascularity into adulthood.
- These changes include a smaller and more irregularly shaped FAZ, decreased juxtafoveal vascular density, and a shallower foveal pit.
Implications
- The study suggests that premature birth affects macular development, resulting in structural and vascular alterations detectable by OCT-A.
- Given the increased risks of glaucoma, high refractive error, retinal tears, and retinal detachments in this population, some advocate for lifelong retina monitoring in premature-birth adults.