Purpose: We investigated optic nerve head morphology in children born preterm with and without retinopathy of prematurity (ROP), focusing on peripapillary retinal nerve fiber layer (pRNFL) thickness, minimal rim width (MRW), Bruch's membrane opening (BMO), and vertical cup-to-disc ratio (vCDR) in relation to perinatal factors (gestational age [GA], birth weight [BW], perinatal adverse events [PAE]).
Methods: This prospective observational cohort included 793 former preterm children aged four to 17 years, stratified into late preterm (GA 33-36 weeks), moderate preterm (GA 29-32 weeks), extreme preterm (GA ≤28 weeks), preterm with untreated ROP, preterm with ROP treatment, and full-term controls (GA ≥37 weeks). Effects of perinatal factors on pRNFL, MRW, BMO area, and vCDR were evaluated.
Results: Extremely preterm children had a thinner pRNFL (β = -9.25, P < 0.001), except temporally. ROP-treated children showed thicker temporal (β = 43.31, P < 0.001) and inferotemporal (β = 20.97, P = 0.04) pRNFL but thinner superonasal sectors. PAE (β = -7.68, P < 0.001) and maternal smoking (temporal β = -12.02, P = 0.003) were associated with thinner pRNFL, whereas breastfeeding was linked to thicker pRNFL (β = 2.25, P = 0.003). MRW was thinner in extremely preterm infants, particularly inferiorly (inferotemporal β = -30.36, inferonasal β = -28.85, all P ≤ 0.02). VCDR was larger in extreme (β = 0.05, P = 0.001) and moderate (β = 0.04, P = 0.004) preterms. BMO area showed no associations.
Conclusions: Prematurity was associated with thinner pRNFL, smaller MRW, and larger vCDR. ROP treatment was linked to thicker temporal pRNFL and thicker MRW. PAE and maternal smoking were associated with thinner pRNFL, whereas breastfeeding correlated with greater thickness.