Skip to main content

Advertisement

SpringerLink
Log in

Evaluating the association of clinical factors and optical coherence tomography retinal imaging with axial length and axial length growth among preterm infants

  • Retinal Disorders
  • Published:
Graefe's Archive for Clinical and Experimental Ophthalmology Aims and scope Submit manuscript

Abstract

Purpose

To study the association of clinical factors and optical coherence tomography (OCT) retinal imaging with axial length (AL) and AL growth in preterm infants

Methods

Among a subgroup of infants from the prospective BabySTEPS study who were screened for retinopathy of prematurity (ROP) and had both AL measured and OCT imaging performed, we analyzed data collected prior to 42 weeks postmenstrual age (PMA) and prior to ROP treatment. Using linear mixed effects models, we evaluated associations between AL and AL growth with gestational age (GA), birthweight, PMA, sex, race, multiparity, maximum ROP stage, and OCT features.

Results

We included 66 infants (132 eyes), mean GA = 27.6 weeks (SD = 2.3; range: 23.0–34.4) and mean birthweight = 961 g (SD = 269, range: 490–1580). In the final predictive model, longer AL was associated with earlier GA, higher birthweight, later PMA, non-White race, and thicker subfoveal choroid (all p values ≤ 0.01). AL increased linearly up to 42 weeks PMA. There was no difference in AL growth rate by GA, sex, race, multiparity, maximum ROP severity, central foveal thickness, or subfoveal choroidal thickness (all p values > 0.05); but AL growth rate was slower in infants with lower birthweight (p = 0.01).

Conclusions

Among preterm infants, those with earlier GA, higher birthweight, later PMA, non-White race, and thicker subfoveal choroid had the longest AL. AL increased linearly up to 42 weeks PMA and lower birthweight was associated with slower AL growth. These findings may improve the accuracy of measurements taken on preterm infants using imaging techniques affected by AL (e.g., measuring lateral dimensions on OCT).

Trial registration

https://clinicaltrials.gov/ct2/show/NCT02887157, date of registration: August 25, 2016

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1

Similar content being viewed by others

Availability of data and materials

A summary, de-identified data set will be made available upon request through direct inquiries to the study principal investigator (C.A.T.) or the coordinating center a year after relevant print publication.

Code availability

Proprietary software application

References

  1. Vajzovic L, Hendrickson AE, O'Connell RV, Clark LA, Tran-Viet D, Possin D, Chiu SJ, Farsiu S, Toth CA (2012) Maturation of the human fovea: correlation of spectral-domain optical coherence tomography findings with histology. Am J Ophthalmol 154:779–89 e2

    Article  Google Scholar 

  2. Vajzovic L, Rothman AL, Tran-Viet D, Cabrera MT, Freedman SF, Toth CA (2015) Delay in retinal photoreceptor development in very preterm compared to term infants. Invest Ophthalmol Vis Sci 56:908–913

    Article  Google Scholar 

  3. Chen X, Prakalapakorn SG, Freedman SF, Vajzovic L, Toth CA. (2019) Differentiating retinal detachment and retinoschisis using handheld optical coherence tomography in stage 4 retinopathy of prematurity. JAMA Ophthalmol

  4. Linderman R, Salmon AE, Strampe M, Russillo M, Khan J, Carroll J (2017) Assessing the accuracy of foveal avascular zone measurements using optical coherence tomography angiography: segmentation and scaling. Transl Vis Sci Technol 6:16

    Article  Google Scholar 

  5. Gordon RA, Donzis PB (1985) Refractive development of the human eye. Arch Ophthalmol 103:785–789

    Article  CAS  Google Scholar 

  6. Cook A, White S, Batterbury M, Clark D (2003) Ocular growth and refractive error development in premature infants without retinopathy of prematurity. Invest Ophthalmol Vis Sci 44:953–960

    Article  Google Scholar 

  7. Cook A, White S, Batterbury M, Clark D (2008) Ocular growth and refractive error development in premature infants with or without retinopathy of prematurity. Invest Ophthalmol Vis Sci 49:5199–5207

    Article  Google Scholar 

  8. Laws DE, Haslett R, Ashby D, O'Brien C, Clark D (1994) Axial length biometry in infants with retinopathy of prematurity. Eye (Lond) 8(Pt 4):427–430

    Article  Google Scholar 

  9. Ozdemir O, Ozen Tunay Z, Erginturk AD (2016) Growth of biometric components and development of refractive errors in premature infants with or without retinopathy of prematurity. Turk J Med Sci 46:468–473

    Article  CAS  Google Scholar 

  10. Fieß A, Kolb-Keerl R, Knuf M, Kirchhof B, Blecha C, Oberacher-Velten I, Muether PS, Bauer J (2017) Axial length and anterior segment alterations in former preterm infants and full-term neonates analyzed with scheimpflug imaging. Cornea 36:821–827

    Article  Google Scholar 

  11. Ozdemir M, Koylu S (2009) Ocular growth and morbidity in preterm children without retinopathy of prematurity. Jpn J Ophthalmol 53:623–628

    Article  Google Scholar 

  12. Zhu X, Zhao R, Wang Y, Ouyang L, Yang J, Li Y, Pi L (2017) Refractive state and optical compositions of preterm children with and without retinopathy of prematurity in the first 6 years of life. Medicine (Baltimore) 96:e8565

    Article  Google Scholar 

  13. Kent D, Pennie F, Laws D, White S, Clark D (2000) The influence of retinopathy of prematurity on ocular growth. Eye (Lond) 14(Pt 1):23–29

    Article  Google Scholar 

  14. Mangalesh S, McGeehan B, Tai V, Chen X, Tran-Viet D, Vajzovic L, Viehland C, Izatt JA, Cotten CM, Freedman SF, Maguire M, Toth CA, Baby SG. (2020) Macular optical coherence tomography characteristics at 36 weeks postmenstrual age in infants examined for retinopathy of prematurity. Ophthalmol Retina

  15. Husain SM, Sinha AK, Bunce C, Arora P, Lopez W, Mun KS, Reddy MA, Adams GG (2013) Relationships between maternal ethnicity, gestational age, birth weight, weight gain, and severe retinopathy of prematurity. J Pediatr 163:67–72

    Article  Google Scholar 

  16. Ng YK, Fielder AR, Shaw DE, Levene MI (1988) Epidemiology of retinopathy of prematurity. Lancet 2:1235–1238

    Article  CAS  Google Scholar 

  17. Saunders RA, Donahue ML, Christmann LM, Pakalnis AV, Tung B, Hardy RJ, Phelps DL (1997) Racial variation in retinopathy of prematurity. The cryotherapy for retinopathy of prematurity cooperative group. Arch Ophthalmol 115:604–608

    Article  CAS  Google Scholar 

  18. Tadesse M, Dhanireddy R, Mittal M, Higgins RD (2002) Race, Candida sepsis, and retinopathy of prematurity. Biol Neonate 81:86–90

    Article  Google Scholar 

  19. Lavric A, Tekavcic Pompe M, Markelj S, Ding J, Mahajan S, Khandelwal N, Agrawal R (2019) Choroidal structural changes in preterm children with and without retinopathy of prematurity. Acta Ophthalmol

  20. Baker PS, Tasman W (2008) Myopia in adults with retinopathy of prematurity. Am J Ophthalmol 145:1090–1094

    Article  Google Scholar 

  21. Moreno TA, O'Connell RV, Chiu SJ, Farsiu S, Cabrera MT, Maldonado RS, Tran-Viet D, Freedman SF, Wallace DK, Toth CA (2013) Choroid development and feasibility of choroidal imaging in the preterm and term infants utilizing SD-OCT. Invest Ophthalmol Vis Sci 54:4140–4147

    Article  Google Scholar 

  22. Jin P, Zou H, Zhu J, Xu X, Jin J, Chang TC, Lu L, Yuan H, Sun S, Yan B, He J, Wang M, He X (2016) Choroidal and retinal thickness in children with different refractive status measured by swept-source optical coherence tomography. Am J Ophthalmol 168:164–176

    Article  Google Scholar 

  23. Jin P, Zou H, Xu X, Chang TC, Zhu J, Deng J, Lv M, Jin J, Sun S, Wang L, He X (2019) Longitudinal changes in choroidal and retinal thicknesses in children with myopic shift. Retina 39:1091–1099

    Article  Google Scholar 

  24. Xiong S, He X, Deng J, Lv M, Jin J, Sun S, Yao C, Zhu J, Zou H, Xu X (2017) Choroidal thickness in 3001 Chinese children aged 6 to 19 years using swept-source OCT. Sci Rep 7:45059

    Article  CAS  Google Scholar 

  25. Xiang F, He M, Morgan IG (2012) Annual changes in refractive errors and ocular components before and after the onset of myopia in Chinese children. Ophthalmology 119:1478–1484

    Article  Google Scholar 

  26. Read SA, Alonso-Caneiro D, Vincent SJ, Collins MJ (2015) Longitudinal changes in choroidal thickness and eye growth in childhood. Invest Ophthalmol Vis Sci 56:3103–3112

    Article  Google Scholar 

Download references

Acknowledgements

The authors thank Katrina P. Winter, BS for performing segmentation correction and helping with data analysis.

Funding

This study was supported by funding from the National Institutes of Health (NIH) Grants R01 EY025009 and P30 EY005722. Contents of this manuscript are solely the responsibility of the authors and do not necessarily represent the official view of the NIH. The sponsors or funding organizations had no role in the design or conduct of this research.

Author information

Authors and Affiliations

  1. Department of Ophthalmology, Duke University, 2351 Erwin Rd, DUMC 3802, Durham, 27710, NC, USA

    S. Grace Prakalapakorn, Nikhil Sarin, Neeru Sarin, Du Tran-Viet, Vincent Tai, Cynthia A. Toth & Sharon F. Freedman

  2. Department of Pediatrics, Duke University, Durham, NC, USA

    S. Grace Prakalapakorn & Sharon F. Freedman

  3. Center for Preventative Ophthalmology and Biostatistics, Philadelphia, PA, USA

    Brendan McGeehan

  4. Department of Ophthalmology, Scheie Eye Institute, University of Pennsylvania, Perelman School of Medicine, Philadelphia, PA, USA

    Gui-Shuang Ying

Authors
  1. S. Grace Prakalapakorn
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Nikhil Sarin
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Neeru Sarin
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Brendan McGeehan
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. Du Tran-Viet
    View author publications

    You can also search for this author in PubMed Google Scholar

  6. Vincent Tai
    View author publications

    You can also search for this author in PubMed Google Scholar

  7. Gui-Shuang Ying
    View author publications

    You can also search for this author in PubMed Google Scholar

  8. Cynthia A. Toth
    View author publications

    You can also search for this author in PubMed Google Scholar

  9. Sharon F. Freedman
    View author publications

    You can also search for this author in PubMed Google Scholar

Contributions

All authors contributed to the study conception and design. Data collection was performed by S. Grace Prakalapakorn, Neeru Sarin, Du Tran-Viet, Vincent Tai, and Sharon F. Freedman. Data analysis was performed by Nikhil Sarin, Brendan McGeehan, Vincent Tai, and Gui-Shuang Ying. The first draft of the manuscript was written by S. Grace Prakalapakorn, and all authors commented on previous versions of the manuscript. All authors read and approved the final manuscript.

Corresponding author

Correspondence to S. Grace Prakalapakorn.

Ethics declarations

Ethics approval

All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards. This study was approved by the Duke Health System Institutional Review Board (IRB number: Pro00069721). The study is listed at ClinicalTrials.gov (NCT 02887157).

Consent to participate

Written informed consent was obtained from a parent/legal guardian of all individual participants prior to study participation.

Consent for publication

Written informed consent was obtained from a parent/legal guardian of all individual participants prior to study participation.

Conflict of interest

Dr. Toth receives royalties through her university from Alcon. She is a co-founder and equity owner of Theia Imaging, LLC (Chapel Hill, NC). Through her university, she also has unlicensed and pending patents regarding OCT technology and methods.

Additional information

Publisher’s note

Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

Supplementary Information

ESM 1

(XLSX 11 kb)

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Prakalapakorn, S.G., Sarin, N., Sarin, N. et al. Evaluating the association of clinical factors and optical coherence tomography retinal imaging with axial length and axial length growth among preterm infants. Graefes Arch Clin Exp Ophthalmol 259, 2661–2669 (2021). https://doi.org/10.1007/s00417-021-05158-4

Download citation

  • Received:

  • Revised:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s00417-021-05158-4

Keywords

Search

Navigation