Visual Function and Fundus Morphology in Relation to Growth and Cardiovascular Status in 10-Year-Old Moderate-to-Late Preterm Children

Am J Ophthalmol. 2018 Nov:195:121-130. doi: 10.1016/j.ajo.2018.07.037. Epub 2018 Aug 4.

Abstract

Purpose: To study visual function and ocular fundus morphology in relation to growth, metabolic status, and blood pressure in moderate-to-late preterm (MLP) children at 10 years of age.

Design: Prospective cohort study.

Methods: In this population-based observational study, nonsyndromic MLP children born in Gothenburg, Sweden, were examined neonatally in the years 2002-2003 concerning length, weight, head circumference, and insulin-like growth factor I (IGF-I). At 10 years of age, 33 children (10 girls) were examined regarding previously mentioned variables, and regarding visual acuity, refraction, fundus morphology, IGF binding protein 3, leptin, adiponectin, and blood pressure. An age- and sex-matched control group consisted of 28 children (9 girls).

Results: Myopia was more commonly found in MLP children than in controls (P = .004, 95% CI 1.8 to 49.8). The MLP group had smaller optic disc area (P = .01, 95% CI -0.5 to -0.1), smaller rim area (P = .001, 95% CI -0.5 to -0.2), fewer branching points (P = .0001, 95% CI -5.7 to -2.1), and higher index of tortuosity of arteries (P = .03, 95% CI 0.002 to 0.03) and veins (P = .02, 95% CI 0.003 to 0.02). Refraction correlated with IGF-I (P = .0005, rs = 0.60 in right eye, and P = .002, rs = 0.55 in left eye) at 10 years of age. Tortuosity of arteries at assessment correlated with neonatal IGF-I levels (P = .03, rs = -0.39). Tortuosity of veins correlated with a leptin/adiponectin ratio at assessment (P = .04, rs = 0.37).

Conclusion: The findings suggest that being born MLP is associated with myopia, smaller optic disc and rim areas, and abnormal retinal vascularization. Furthermore, metabolic status and growth factors seem to have an impact on ocular development.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adiponectin / blood
  • Blood Pressure / physiology
  • Body Constitution
  • Cardiovascular Physiological Phenomena*
  • Child
  • Enzyme-Linked Immunosorbent Assay
  • Eye / growth & development*
  • Female
  • Fundus Oculi
  • Gestational Age
  • Humans
  • Insulin-Like Growth Factor I / metabolism
  • Leptin / blood
  • Male
  • Myopia / pathology*
  • Optic Disk / abnormalities*
  • Premature Birth*
  • Prospective Studies
  • Radioimmunoassay
  • Refraction, Ocular / physiology
  • Retinal Vessels / abnormalities*
  • Visual Acuity / physiology*

Substances

  • ADIPOQ protein, human
  • Adiponectin
  • IGF1 protein, human
  • LEP protein, human
  • Leptin
  • Insulin-Like Growth Factor I