Retinal structural changes in preterm children without retinopathy of prematurity

Diogo Maleita, Rita Serras-Pereira, Inês Passos, Maria Elisa-Luís, Marta Alves, Ana Luísa Papoila, Cristina Brito, João Paulo Cunha, Joana Tavares Ferreira

Research output: Contribution to journalArticlepeer-review


Purpose: The aim of this study was to compare all retinal layers’ thickness in full-term and preterm children without retinopathy of prematurity (ROP). Methods: Cross-sectional study including two groups of patients: group 1 children with history of preterm gestation without ROP (gestational age < 37 weeks) and group 2 healthy children with history of full-term gestation. All subjects underwent an ophthalmic examination including spectral domain-optical coherence tomography. After automatic retinal segmentation, each retinal layer thickness (eight separate layers and overall thickness) was calculated in all nine Early Treatment Diabetic Retinopathy Study areas. Demographic, systemic, gestational, and birth data were collected. Generalized additive regression models were used to analyze the data. Results: Fifty-one children (51 eyes) were recruited, 19 full-term and 32 preterm children, mean age at ophthalmic examination of 10.58 (4.21) and 14.13 (3.16), respectively. In multivariable analysis, the preterm group’s retinal thickness was significantly decreased in total retina nasal outer sector, ganglion cell layer (GCL), and inner plexiform layer (IPL), specifically GCL temporal outer (p = 0.010), GCL superior outer (p = 0.009), IPL temporal outer (p = 0.022), and IPL superior outer (p = 0.004), when compared with full-term group. From the variables compared only with birth head circumference that influenced the models, a non-linear association was identified and consequently modeled with splines through a generalized additive model. Conclusion: This study suggests that preterm children without ROP have structural retinal alterations, mostly in GCL and IPL in outer areas of the macula. Therefore, it is crucial to question gestational history since these retinal changes may be found later in life leading to useless investigation. [Figure not available: see fulltext.].

Original languageEnglish
Pages (from-to)1025-1033
JournalGraefe's Archive for Clinical and Experimental Ophthalmology
Issue number4
Early online date4 Nov 2020
Publication statusPublished - Apr 2021


  • Ganglion cell layer
  • Inner plexiform layer
  • Optical coherence tomography
  • Preterm children
  • Retinal layer thickness


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