Association of Birth Weight with Central and Peripheral Corneal Thickness in Adulthood—Results from the Population-Based German Gutenberg Health Study

Abstract

Purpose: Low birth weight (BW) is associated with altered ocular geometry such as a steeper corneal shape in adulthood. However, it is unclear whether low birth weight affects corneal thickness development in the center or periphery in adulthood which may contribute to ocular disease. The purpose of this study was to investigate corneal thickness in former low birth weight individuals in adulthood. Methods: The German Gutenberg Health Study is a prospective, population-based study in which every participant (age range 40–80 years) was measured with Scheimpflug imaging (Pentacam HR, Oculus Optikgeräte GmbH, Wetzlar, Germany). BW was collected by self-reports. The relationship between birth weight and corneal thickness at different locations were assessed. Linear regression models were carried out including uni- and multivariable analyses with adjustment for age, sex, mean corneal radius, and white-to-white distance. Main outcome measures were corneal thickness at the apex, at the pupil center, and at the corneal periphery. Results: Overall, 5657 participants were successfully measured (3019 females, aged 56.0 ± 10.3 years). In multivariable analyses a lower BW was associated with a thinner corneal thickness at the apex (B = 1.71 µm/500 g, p < 0.001) and at the pupil (B = 1.69 µm/500 g, p < 0.001). These effects diminished towards the corneal periphery resulting in no differences in the perilimbal regions. Conclusion: The present study provides evidence that lower birth weight goes along with corneal thickness alterations even into adult ages of 40 to 80 years. Thinner measurements of the cornea were particularly found in the corneal center and diminished in the periphery. This indicates that there may be fetal origins affecting corneal thickness development particularly in the corneal center.

The role of preterm birth, retinopathy of prematurity and perinatal factors on corneal aberrations in adulthood: Results from the Gutenberg prematurity eye study

“…One reason might be changes in corneal remodelling processes and ultrastructural alterations in collagen fibre development, as well as an altered duration of corneal hydration, evaporation and remodelling processes due to adverse perinatal nutrition. Furthermore, absorbed energy during ROP treatment might be another factor contributing to altered corneal aberrations in those subjects 21 . Thus, we assume that preterm birth together with intrauterine malnutrition play an important role in the development of corneal shape.…”

“…Furthermore, absorbed energy during ROP treatment might be another factor contributing to altered corneal aberrations in those subjects. 21 Thus, we assume that preterm birth together with intrauterine malnutrition play an important role in the development of corneal shape.…”

“…[13][14][15] One explanation for altered corneal geometry is the lower extrauterine temperature after preterm birth compared to the higher intrauterine temperature in the maternal environment leading to reduced corneal flattening. 16 In a recent report of the Gutenberg Health Study, the authors reported that low birth weight (<2500 g), as a proxy for preterm delivery, is linked with reduced visual acuity, 17 steeper corneal shape, 18 altered ocular geometry [18][19][20][21][22] and increased corneal aberrations 23 compared to adults with a normal birth weight (2500-4000 g) between 40 and 80 years of age. However, these data were limited because gestational age and the postnatal occurrence of ROP were not surveyed.…”

Dry Eye Parameters and Lid Geometry in Adults Born Extremely, Very, and Moderately Preterm with and without ROP: Results from the Gutenberg Prematurity Eye Study

“…However, the pathophysiological mechanisms remain unclear, and it remains to be determined whether the increased tear evaporation is caused by dysfunction of the Meibomian glands or by reduced mucin from the goblet cells. Other pathophysiological mechanisms causing long-term effects on the corneal surface might be the lower extrauterine temperature after preterm birth compared to the intrauterine environment [ 12 ] and a shorter time in the intrauterine milieu, or different periods of opened eyes in the interval until reaching full GA [ 13 ]. There is evidence that dry eye disease is caused, among other reasons, by subacute inflammation and has many features in common with autoimmune disease [ 16 ].…”

“…There are different hypotheses and models explaining the effects of an altered corneal geometry. For example, Fielder et al hypothesized that the lower extrauterine temperature leads to a decreased flattening of the cornea after preterm birth [ 12 ], whereas other researchers supposed that a shorter time in the intrauterine milieu and different periods of opened eyes [ 13 ] may result in ultrastructural corneal remodeling processes including collagen fiber layers. Impaired prenatal growth also leads to altered organ morphology and functioning [ 14 ], as well as increased inflammation in a hyper-responsive innate immune system [ 15 ].…”