PurposeTo investigate the microstructural differences of the inner retina in the peripapillary and macular areas in children with or without retinopathy of prematurity (ROP).MethodsThis prospective cohort study included school-age children with a history of ROP and age-matched healthy, full-term children. The macular ganglion cell complex (mGCC), peripapillary retinal nerve fiber layer (RNFL), refractive status, and ocular biometry were measured. The metrics of the mGCC and associated anatomical changes were the primary outcomes. Mann-Whitney U tests and chi-squared tests were used to compare variables between the two groups.ResultsA total of 41 eyes from 21 preterm children with ROP and 34 eyes from 17 full-term children were enrolled. ROP eyes had significantly thicker mGCC (P<0.001) with uneven distribution compared with full-term eyes. The RNFLs of ROP eyes were thicker in the temporal quadrants but thinner in the nasal quadrants (P=0.01 and.04, respectively). In addition, the ROP eyes had shallower anterior chamber depths (ACDs), thicker lenses, and higher degrees of refractive errors (all P<0.05) but similar axial lengths (ALs) (P=0.58) compared with full-term eyes.ConclusionsThe mGCC was thicker in children with ROP, and their inner retinal structures had a different distribution pattern than those in full-term children. The myopia of children with ROP was associated with the abnormal development of the anterior segment rather than long ALs. These alterations in inner retinal anatomy and optic components emphasize the importance of careful examinations to monitor the development of glaucoma or visual decline in children with ROP.