Severe retinopathy of prematurity predicts delayed white matter maturation and poorer neurodevelopment

Glass, Torin; Chau, Vann; Gardiner, Joseph; Foong, Justin; Vinall, Jillian; Zwicker, Jill G.; Grunau, Ruth E.; Synnes, Anne; Poskitt, Kenneth J.; Miller, Steven P.

doi:10.1136/archdischild-2016-312533

Cited by 68 publications

(72 citation statements)

References 32 publications

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“…We were able to show that preterm-born children with severe ROP displayed a significantly lower development quotient and lower fine motor scores at 15 and 24 months' CA, which is in agreement with other publications (28,29). Smaller brain volumes and impaired cortical development have been associated with neurodevelopmental deficits that persist through childhood and adolescence (30).…”

Section: Discussionsupporting

confidence: 91%

Severe retinopathy of prematurity is associated with reduced cerebellar and brainstem volumes at term and neurodevelopmental deficits at 2 years

et al. 2018

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BackgroundTo evaluate the association between severe retinopathy of prematurity (ROP), measures of brain morphology at term-equivalent age (TEA), and neurodevelopmental outcome.MethodsEighteen infants with severe ROP (median gestational age (GA) 25.3 (range 24.6-25.9 weeks) were included in this retrospective case-control study. Each infant was matched to two extremely preterm control infants (n=36) by GA, birth weight, sex, and brain injury. T2-weighted images were obtained on a 3 T magnetic resonance imaging (MRI) at TEA. Brain volumes were computed using an automatic segmentation method. In addition, cortical folding metrics were extracted. Neurodevelopment was formally assessed at the ages of 15 and 24 months.ResultsInfants with severe ROP had smaller cerebellar volumes (21.4±3.2 vs. 23.1±2.6 ml; P=0.04) and brainstem volumes (5.4±0.5 ml vs. 5.8±0.5 ml; P=0.01) compared with matched control infants. Furthermore, ROP patients showed a significantly lower development quotient (Griffiths Mental Development Scales) at the age of 15 months (93±15 vs. 102±10; P=0.01) and lower fine motor scores (10±3 vs. 12±2; P=0.02) on Bayley Scales (Third Edition) at the age of 24 months.ConclusionSevere ROP was associated with smaller volumes of the cerebellum and brainstem and with poorer early neurodevelopmental outcome. Follow-up through childhood is needed to evaluate the long-term consequences of our findings.

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Section: Discussionsupporting

confidence: 91%

Severe retinopathy of prematurity is associated with reduced cerebellar and brainstem volumes at term and neurodevelopmental deficits at 2 years

et al. 2018

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“…As previous studies have reported the association between white matter maturation delay and cognitive outcomes in children born preterm, 12,29 our findings may provide functional implications in preterm infants with ROP. Clinical outcomes of ROP have improved greatly since the introduction of laser and anti-vascular endothelial growth factor therapy for severe retinopathy.…”

Section: Discussionsupporting

confidence: 69%

Diffusion Tensor Imaging Analysis of White Matter Microstructural Integrity in Infants With Retinopathy of Prematurity

Ahn

Park

Lee

et al. 2019

Invest. Ophthalmol. Vis. Sci.

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PURPOSE. To investigate white matter maturation in preterm infants with and without retinopathy of prematurity (ROP) and to determine whether ROP is associated with white matter microstructural integrity at term-equivalent ages. METHODS. In 82 preterm and 34 full-term infants who had undergone brain magnetic resonance imaging diffusion tensor imaging at term-equivalent ages, white matter microstructural integrity was assessed based on mean fractional anisotropy (FA) and mean diffusivity (MD) values in 23 predefined regions of interest by using atlas-based analyses. The values were compared among preterm and full-term infants, and a general linear model was used to evaluate the association of the values with ROP or severe (i.e., stage ‡3) ROP. RESULTS. Significant differences in FA and MD values were observed among preterm and fullterm infants in 17 (73.9%) and 15 (65.2%) of the 23 white matter areas evaluated, respectively. However, ROP was significantly associated with MD values in only two areas (superior longitudinal fasciculus [P ¼ 0.030] and cerebral peduncle [P ¼ 0.005]). Severe ROP was significantly associated with FA values within the anterior limb of the internal capsule (P ¼ 0.049) and MD values within the stria terminalis (P ¼ 0.035). A network analysis showed that preterm infants with severe ROP had lower small-world index values than those without. CONCLUSIONS. Preterm birth may be more strongly associated with white matter maturation at term-equivalent ages than ROP, but severe ROP may be associated with decreased structural connectivity.

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“…In line with our outcome, several publications have emphasised the risk of late death or major disabilities in childhood born preterm with severe ROP or BPD. Farooqi et al.…”

Section: Discussionsupporting

confidence: 75%

Model that predicted death or disabilities in premature infants was valid at seven years of age

et al. 2019

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Aim Validated a model that used bronchopulmonary dysplasia (BPD), brain injuries measured using ultrasound and retinopathy of prematurity (ROP) to predict late death or disability in premature infants at seven years of age. Methods A retrospective study was performed at the 12 de Octubre Hospital neonatal unit in Madrid. A logistic model was applied to estimate the independent prognostic contribution of each morbidity, and the effect that the combination of morbidities had on the seven‐year outcomes. The analysis was performed on the total cohort from 1991 to 2008 and on two subcohorts from 1991 to 1998 and 1999 to 2008. Results A total of 1001 children were included with a mean birth weight of 922 ± 208 g. Severe ROP was strongly associated with poor neurodevelopment, with an odds ratio (OR) 3.17 and 95% confidence interval (CI) of 1.56–6.50, and so was BPD (OR 1.52, 95% CI: 1.03–2.2). The combination of two neonatal morbidities increased the risk of a poor outcome (OR 4.44, 95% CI: 1.51–7.86). The model behaved differently in the two subcohorts. Conclusion The prognostic model predicted a poor outcome at seven years of age when the subjects had at least two of the three morbidities.

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Severe retinopathy of prematurity predicts delayed white matter maturation and poorer neurodevelopment

Abstract: Severe ROP is associated with maturational delay in the optic radiations, PLIC, external capsule and posterior white matter, housing the primary visual and motor pathways, and is associated with poorer cognitive and motor outcomes at 18 months' CA.

Cited by 68 publications

References 32 publications

Severe retinopathy of prematurity is associated with reduced cerebellar and brainstem volumes at term and neurodevelopmental deficits at 2 years

Severe retinopathy of prematurity is associated with reduced cerebellar and brainstem volumes at term and neurodevelopmental deficits at 2 years

Diffusion Tensor Imaging Analysis of White Matter Microstructural Integrity in Infants With Retinopathy of Prematurity

Model that predicted death or disabilities in premature infants was valid at seven years of age

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