Background/aim: Previous studies have revealed various subnormal visual functions in

AimTo investigate the retinal nerve fibre layer (RNFL) with optical coherent tomography (OCT) in prematurely-born children.Methods62 children born with a gestational age of ≤32 weeks, and a control group of 54 children born at term with normal birth weight (BW) were included in the study. 28 of the preterm children had retinopathy of prematurity (ROP) in the neonatal period; eight of them had severe ROP (stages 3–4). RNFL thickness was measured with Stratus OCT 3. Mean age at examination was 8.6 years in the preterm children and 10.1 years in the control group.ResultsThere was a significant difference between the children born preterm and those born at term, regarding RNFL thickness in the superior (right eye (RE), p=0.043; left eye (LE), p=0.048) and the nasal quadrants (RE, p=0.006; LE, p<0.001), as well as average RNFL thickness (RE, p=0.016; LE, p=0.029). This difference was caused by the thinner RNFL in children with previous severe ROP (stages 3 and 4). Within the preterm group, the average RNFL thickness increased with larger BW (RE, p=0.050; LE, p=0.028), but there was no correlation with gestational age at birth.ConclusionThe RNFL was reduced in prematurely-born children with severe ROP when compared to children born at term. It is hypothesised that severe retinopathy as well as ablation of the retina with laser treatment or cryotherapy may affect the axons of the ganglion cells and thus reduce RNFL thickness. Prematurely-born children with low BW had a thinner RNFL, suggesting a negative effect of low birth weight on neural development.

ABSTRACT.Purpose: To discuss treatment modalities for aggressive posterior retinopathy of prematurity (AP-ROP). Methods: The medical charts of all infants with AP-ROP at Uppsala University Hospital, Sweden, during a 2-year period (2009 and 2010) were reviewed. Eight infants (16 eyes) with a mean gestational age of 23.8 weeks and a mean birth weight of 592 g were treated with laser and ⁄ or intravitreal injections of bevacizumab (0.4 and 0.625 mg). RetCam photography was used to document the retinal appearance before and after treatment. Results: All infants (16 eyes) had AP-ROP in zone I. Mean time at initial treatment was 34 weeks postmenstrual age. Two eyes (one infant) were only treated with laser, and six eyes (three infants) were treated with laser therapy or cryopexy and, because of lack of regression, with bevacizumab as salvage therapy. Eight eyes (four infants) were treated with a first-line bevacizumab injection and four of these eyes (two infants) with additional laser ablation for continued disease progression in zone II. Macular dragging occurred in one eye of one infant primarily treated with laser. Conclusions: Given the high complication rate of the extensive laser treatment for zone I ROP, it is worth considering anti-vascular endothelial growth factor treatment as an alternative therapy. Further knowledge concerning side effects and long-term ocular and systemic outcome is warranted before this drug becomes general clinical practice.

The present study illustrates that electrophysiological studies of the retinal function can help us understand visual dysfunctions in prematurely born children.

PurposeMacular development is a complex process that starts by mid-gestation and continues several years after birth. A preterm birth could affect this development, causing increased thickness in the central macula, but the effect of the macular function remains uncertain. The aim of this study was to investigate the macular function measured with multifocal electroretinography (mfERG), in former preterm children and compare with healthy controls. A second aim was to correlate central macular function with central macular thickness measured with optical coherent tomography (OCT), in the preterm group.MethodsFifteen former preterm children born before 32 weeks of gestation were included in the study. MfERG results from 12 children acted as controls. Visual acuity, refraction in cycloplegia and mfERG were carried out in all children, and optical coherent tomography (OCT) was performed in the preterm children. Main outcomes were P1 amplitudes and implicit times for Rings 1–5 and “sum of groups” of the mfERG, and central macula thickness in area A1 measured with OCT.ResultsThe P1 amplitudes were reduced in Rings 1–5 and “Sum of groups” in the preterm children compared to controls. There were no significant correlation between P1 amplitude or implicit times in Ring 1 and central macular thickness in the preterm group.ConclusionsMacular function is reduced in former preterm children compared to children born at term. This suggests that the structural changes with a thicker central retina can have an effect on function and may be one, of probably several, explanations for visual dysfunction in preterm children at school age.