83 - Associations between perinatal systemic health factors and retinal findings in preterm infants

Monday, May 1, 2023

9:30 AM – 11:30 AM ET

Poster Number: 83
Publication Number: 83.43

Shwetha Mangalesh, Duke University School of Medicine, Durham, NC, United States; Neeru Sarin, Duke University School of Medicine, Durham, NC, United States; Brendan McGeehan, Perelman School of Medicine at the University of Pennsylvania, Philadelphia, PA, United States; Vincent Tai, Duke University School of Medicine, Durham, NC, United States; Liangbo Shen, University of California, San Francisco, School of Medicine, San Francisco, CA, United States; Xi Chen, Duke University School of Medicine, Durham, NC, United States; Noelle Younge, Duke University School of Medicine, Durham, NC, United States; Gui-shuang Ying, University of Pennsylvania, Philadelphia, PA, United States; Charles M. Cotten, Duke University, Durham, NC, United States; Cynthia A. Toth, Duke Eye Center - Durham, NC, Durham, NC, United States

Presenting Author(s)

Shwetha Mangalesh, MD (she/her/hers)

Postdoctoral Fellow
Duke University School of Medicine
Durham, North Carolina, United States

Background:

The increased survival of preterm infants has necessitated efforts to improve their long-term outcomes. Neonatal insults not only impact mortality but also lead to long-term disabilities. As an extension of the central nervous system, the retina is also impacted by systemic inflammation and injury. Therefore, bedside retinal imaging may be useful for the non-invasive evaluation and monitoring of infants’ systemic health status.

Objective:

We aimed to investigate the associations between perinatal systemic health factors and optical coherence tomography (OCT)-based retinal microanatomical findings in preterm infants at 36 weeks postmenstrual age (PMA).

Design/Methods:

We included 85 preterm infants eligible for retinopathy of prematurity screening, enrolled in the STudy of Eye imaging in Preterm infantS (BabySTEPS) with OCT imaging at 36±1 weeks PMA. We analyzed the associations between perinatal systemic health factors, including pulmonary, cardiac, neurological and inflammatory conditions, with OCT-based retinal layer thicknesses measured at two locations: 1. Fovea - a depression in the central neurosensory retina determining visual acuity, and 2. Nasal parafovea - 1000µm nasal to the fovea. An average of measurements from both eyes was used for univariable and multivariable analysis.

Results:

We found that infants with septicemia or necrotizing enterocolitis (NEC, n=16) had thicker total and outer retina than those without (mean± standard deviation, 316±27µm vs 222±13µm, p=0.002 and 110±7µm vs 79±3µm, p≤0.001) at foveal center, and thicker inner nuclear layer at the nasal parafovea (98±7µm vs 76±3µm, p=0.006). Infants with intracranial hemorrhage/periventricular leukomalacia/ventriculomegaly (n=30) had thinner inner retina (124±3µm versus 134±2µm, p=0.001) and infants with higher weight at OCT imaging had a thicker inner retina (2.15µm per 250g, 95% CI= 0.42, 3.88; p=0.01) at the nasal parafovea.

Conclusion(s):

Perinatal systemic inflammatory conditions, brain injury and infant weight were associated with retinal thickness changes on bedside OCT imaging. Our study highlights the effect of systemic health on the preterm retina, independent of prematurity-related birth factors. Future longitudinal studies may help establish the long-term impact of infant systemic health on the retina and visual outcomes.