Retinal structure assessed by OCT as a biomarker of brain development in children born small for gestational age

Pueyo, Victoria; Pérez, Tania; González, Inmaculada; Altemir, Irene; Giménez, Galadriel; Prieto, Esther; Paulés, Cristina; López-Pisón, J; Fayed, Nicolás; García-Martí, Gracián; Sanz-Requena, Roberto; Marín, Miguel Ángel Fernández-Villacañas

doi:10.1136/bjophthalmol-2016-309790

Cited by 9 publications

(13 citation statements)

References 28 publications

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“…These results are consistent with those found in two previous studies, where preterm infants who were SGA had thinner GCL‐IPL and mRNFL (Pueyo et al. 2015, 2017). In our study, we observed that the 33–34 weekers, who were included for weighing less than 1500 g at birth and were all SGA, presented a reduction in total mRNFL, but not in GCL‐IPL thickness, associated with lower birth weight.…”

Section: Discussionsupporting

confidence: 93%

“…The association between GCL-IPL thickness and prematurity is controversial. Some studies report thicker GCL-IPL in preterm children (Yanni et 2012;Raffa et al 2016), whereas others report thinner GCL-IPL in preterm children (Pueyo et al 2015(Pueyo et al , 2017Fieß et al 2017). Similar observations can be made for mRNFL, with no difference in some studies (Raffa et al 2016) and thickening (Balasubramanian et al 2019) and thinning (Pueyo et al 2015) in preterm children in others.…”

Section: Visual Acuity Mean (Sd) Rangesupporting

confidence: 57%

“…2016), whereas others report thinner GCL‐IPL in preterm children (Pueyo et al. 2015, 2017; Fieß et al. 2017).…”

Section: Discussionmentioning

confidence: 97%

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Retinal ganglion cell complex thickness at school‐age, prematurity and neonatal stressors

Ortueta‐Olartecoechea

Torres-Peña

Muñoz-Gallego

et al. 2021

Acta Ophthalmologica

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Purpose: To investigate the association between the ganglion cell complex (GCC) thickness at early school-age and prematurity and other neonatal factors. Methods: Cross-sectional study. The sample included very preterm children with gestational age (GA) below 32 weeks or birthweight below 1500 g enrolled in a follow-up program (n = 101) and a comparison group of term-born children (n = 49). Ganglion cell complex (GCC) thickness was measured at 4-8 years using high-quality optical coherence tomography (OCT) images. Data on neonatal and postnatal features were extracted from clinical records; analyses included mixed linear models. Results: Ganglion cell layer (GCL) and retinal nerve fiber layer (mRNFL) were thicker in term than in preterm born children (2.9 lm and 2.4 lm respectively, p < 0.001). Within the preterm group, lower GA was associated with a decrease in total GCL (0.7 lm per week, p < 0.001). Being small for GA was associated with further thinning in both layers (1.4 and 2.8 µm). Postnatal corticosteroids therapy and severe brain lesion were associated with thinning in the total GCL of 6 µm (p < 0.001) and 4.1 µm (p = 0.002), respectively, and shock was associated with thinning in total mRNFL of 6 µm (p < 0.001). Conclusions: Lower GA or birthweight are associated with thinning of GCC layers. When performing an OCT examination at school-age and a decrease in GCC thickness is observed, it may be relevant to ask about a history of prematurity, and further enquire about neonatal shock, postnatal corticosteroids therapy or severe brain lesion that are related to additional decrease in GCC thickness.

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Section: Discussionsupporting

confidence: 93%

Section: Visual Acuity Mean (Sd) Rangesupporting

confidence: 57%

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Retinal ganglion cell complex thickness at school‐age, prematurity and neonatal stressors

Ortueta‐Olartecoechea

Torres-Peña

Muñoz-Gallego

et al. 2021

Acta Ophthalmologica

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“…Previous studies using magnetic resonance imaging (MRI) have reported changes in brain reorganization in small fetuses, demonstrated by differences in regional volumes 17 , brain metabolism 18 and connectivity 19 . In particular, we demonstrated previously significant differences in cortical development and the corpus callosum on MRI in late-onset small fetuses.…”

Section: Introductionmentioning

confidence: 99%

Fetal neurosonography detects differences in cortical development and corpus callosum in late‐onset small fetuses

Paulés

Miranda

Policiano

et al. 2021

Ultrasound in Obstet & Gyne

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Objective To explore whether neurosonography can detect differences in cortical development and corpus callosal length in late‐onset small fetuses subclassified into small‐for‐gestational age (SGA) or growth restricted (FGR). Methods This was a prospective cohort study in singleton pregnancies, including normally grown fetuses (birth weight between the 10th and 90th centiles) and late‐onset small fetuses (estimated fetal weight < 10th centile, diagnosed after 32 weeks of gestation and confirmed by birth weight < 10th centile). Small fetuses were subclassified into SGA (birth weight between the 3rd and 9th centiles and normal fetoplacental Doppler) and FGR (birth weight < 3rd centile and/or abnormal cerebroplacental ratio and/or abnormal uterine artery Doppler). Neurosonography was performed at 33 ± 1 weeks of gestation to assess the depth of the insula, Sylvian fissure and parieto‐occipital sulcus in the axial views and corpus callosal length in the midsagittal plane. Measurements were performed offline using Alma Workstation software and were adjusted by biparietal diameter or cephalic index. Linear regression analysis was used to assess the association between the neurosonographic variables and study group, adjusting for confounding factors such as gender, gestational age at neurosonography, nulliparity and pre‐eclampsia. Results In total, 318 fetuses were included, of which 97 were normally grown and 221 were late‐onset small fetuses that were further subdivided into late‐onset SGA (n = 67) or late‐onset FGR (n = 154). Compared to controls, both SGA and FGR cases showed significantly increased insular depth adjusted for biparietal diameter (median (interquartile range), controls 0.329 (0.312–0.342) vs SGA 0.339 (0.321–0.347) vs FGR 0.336 (0.325–0.349); P = 0.006). A linear tendency to reduced Sylvian fissure depth adjusted for biparietal diameter was also observed across the study groups (mean ± SD, controls 0.148 ± 0.021 vs SGA 0.142 ± 0.025 vs FGR 0.139 ± 0.022; P = 0.003). However, differences were significant only between the FGR and control groups. Corpus callosal length adjusted for cephalic index was significantly reduced in FGR cases compared with both controls and SGA cases, while there was no difference between SGA cases and controls (median (interquartile range), controls 0.500 (0.478–0.531) vs SGA 0.502 (0.487–0.526) vs FGR 0.475 (0.447–0.508); P = 0.005). No differences were found in parieto‐occipital sulcus depth between the three study groups. Conclusion Neurosonography seems to be a sensitive tool to detect subtle structural differences in brain development in late‐onset small fetuses. © 2021 International Society of Ultrasound in Obstetrics and Gynecology.

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“…Esta técnica de imagen ya ha sido utilizada para estudiar otras enfermedades neurodegenerativas, como la esclerosis múltiple o el Alzheimer 13,14 . Pueyo et al 30 demostraron la utilidad del análisis de CCG mediante OCT como marcador de daño neuronal en niños con crecimiento intrauterino retardado, lo cual resulta coherente con nuestros resultados, puesto que todos los niños expuestos a tóxicos -tanto drogas de abuso como tabaco y alcoholmostraron una reducción significativa de la CCG. Por lo tanto, la OCT parece ser una herramienta útil en el estudio de un posible daño perinatal, como en este caso es la exposición prenatal a tóxicos.…”

Section: Discussionunclassified

Efectos de la exposición prenatal a alcohol, tabaco y otras drogas de abuso sobre el desarrollo retiniano

Castillo

González

Prieto

et al. 2019

Archivos de la Sociedad Española de Oftalmología

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Evaluar la estructura retiniana mediante tomografía de coherencia óptica (OCT) en niños con antecedentes de exposición prenatal a tóxicos. Métodos: Se exploraron 49 niños expuestos a tóxicos prenatalmente, de edades comprendidas entre 5 y 18 años. De ellos, 25 tenían antecedentes de exposición prenatal a tabaco, 20 fueron expuestos durante el embarazo a alcohol y 4 a otras drogas de abuso. Todos los niños fueron sometidos a una exploración oftalmológica completa incluyendo la realización de una OCT. Se realizó una comparación frente a un grupo control, pareado por edad, de 25 niños con embarazos controlados sin exposición a tóxicos. Resultados: Los niños expuestos prenatalmente a tóxicos presentan una reducción significativa del espesor medio de la capa de fibras nerviosas de la retina (CFNR) en comparación con los no expuestos (81,5 vs. 99,7; p < 0,005), así como de sus cuatro cuadrantes (CFNR supe

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Retinal structure assessed by OCT as a biomarker of brain development in children born small for gestational age

Abstract: SGA children, both preterm and term born, showed evidence of structural abnormalities in the retina, which may be an accurate and non-invasive biomarker of neuronal damage in brain tissue.

Cited by 9 publications

References 28 publications

Retinal ganglion cell complex thickness at school‐age, prematurity and neonatal stressors

Retinal ganglion cell complex thickness at school‐age, prematurity and neonatal stressors

Fetal neurosonography detects differences in cortical development and corpus callosum in late‐onset small fetuses

Efectos de la exposición prenatal a alcohol, tabaco y otras drogas de abuso sobre el desarrollo retiniano

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