ABSTRACT:The aim of this study was to evaluate the influence of early and later postnatal growth variables on optic disc morphology in children (n ϭ 53) born at gestational age Ͻ32 wk. On fundus photographs taken at a median age of 5.4 y, the optic discs were evaluated using digital image analysis and compared with those of a control group (n ϭ 203). The results were analyzed in relation to gestational age, birth weight (BW) SD score (SDS), IGF-1 weight at postmenstrual age 32 wk (SDS), and weight, length, and head circumference (SDS) at follow-up. The preterm children's optic disc and neuronal rim areas were smaller than in the control group. Low BW (SDS) and weight at wk 32 (SDS) were associated with larger area of the optic cup and reduced neuronal rim area. Preterm children with known brain lesions (n ϭ 6) had significantly larger cups than preterm children without known brain lesions. The association found between both low BW and poor early growth and later reduced neuronal tissue of the optic nerve indicate that early weight gain is important for neural development in preterm children. T he prematurely born infant is prone to neuronal and vascular tissue insults when born into extrauterine life during a sensitive period of maturation of the CNS, when synaptogenesis, apoptosis, myelination, reorganization, and vasculogenesis/angiogenesis take place.Preterm birth carries a high risk for peri-or postnatal brain lesions, and brain damage is a common cause of visual impairment in children in developed countries (1). White matter damage (WMD) occurs in 30 to 50% of children born before 30-wk gestational age (GA) (2,3) or with a birth weight (BW) Ͻ1500 g (4). Periventricular leucomalacia (PVL) is frequent in children born preterm and may cause visual impairment (5) and/or cerebral palsy (6). Intraventricular hemorrhage (IVH) has been reported to occur in 61% of infants born before 34-wk GA (7). It may be associated with variable degrees of ischemia and WMD and can cause hydrocephalus that may further impair vision.Preterm birth as well as poor intrauterine 1 growth in fullterm babies has been shown to be associated with subnormal disc and neuronal rim areas of the optic nerve and with an abnormal retinal vessel pattern (8 -12). McLoone et al. (7) reported, in a group of preterm infants with IVH, a trend toward smaller optic disc, neuronal rim, and cup area with increasing severity of IVH, but only children with IVH grade IV were reported to have a significantly increased incidence of optic nerve hypoplasia. They found no association between the optic disc morphology and timing of brain injury. Large cups in normal-sized optic discs have been reported in preterm children with PVL born at GA Ͻ37 wk (12). In another study, children with PVL had a significantly smaller disc area if the damage was estimated to have occurred before 28 postmenstrual weeks and a larger cup of the optic disc and a smaller neuronal rim area if the cerebral WMD was estimated to have occurred later than 28 postmenstrual weeks (13). Children ...

This study shows that prenatal factors resulting in low BW have persisting effects on early postnatal growth, metabolism and inflammatory response. Future prospective studies will focus on the link between these factors and pathological retinal vessel development in the early postnatal period to find possible preventive strategies.

Our findings showed that ICSI boys have abnormal vessel morphology as demonstrated by a reduced number of central retinal branching points. The difference still remained after elimination of factors earlier shown to be associated with a low number of vascular branching points, i.e. low birth weight and preterm, suggesting other mechanisms responsible for the low number of vascular branching points.

ABSTRACT.Purpose: To investigate visual function and ocular morphology in children born after intracytoplasmic sperm injection (ICSI) and compare them with visual function and ocular morphology in matched children born after spontaneous conception. Methods: A total of 137 children born after ICSI and 159 control children were examined at the age of 5 years in a blinded study. The two groups were matched for age, gender and maternal age. The children underwent a detailed ophthalmological investigation by an ophthalmologist and an orthoptist. Results: A total of 90.4% of the ICSI children had a visual acuity (VA) in the better eye of ‡ 0.8, compared with 93.7% of the controls (NS). No significant differences were found between ICSI children and controls with regard to hyperopia, myopia, astigmatism, heterotropia, stereoscopic vision and convergence. One child with Goldenhar syndrome and one with Marcus Gunn syndrome were observed in the ICSI group. One child in the ICSI group was treated for retinopathy of prematurity. Conclusion: In this limited study group, no significant differences in visual function and/or ocular morphology were found between children born after ICSI and matched control children at the age of 5 years.