Skip to main content

Advertisement

SpringerLink
Log in

Effect of gestational age at birth, sex, and race on foveal structure in children

  • Pediatrics
  • Published:
Graefe's Archive for Clinical and Experimental Ophthalmology Aims and scope Submit manuscript

Abstract

Purpose

Premature birth, race, and sex are contributing risk factors for retinopathy of prematurity (ROP) and have long-term impact on children’s retinal structure. Few studies investigate impact of race and sex on macular structure in children born preterm. This study compared foveal structure in preterm and full-term children.

Methods

Children aged 4–18 years were enrolled into three groups: (1) ROP-risk group (n = 81), born at < 32 weeks gestational age with and without history of ROP; (2) preterm group (n = 46), born at 32–36 weeks gestational age; and (3) control group (n = 68) with full-term birth. Using spectral-domain optical coherence tomography volume-scan images, foveal structure within 1-mm and 3-mm early treatment diabetic retinopathy study circular grid was measured and segmented. Total inner and outer retina thickness of the right eye was compared among the three groups.

Results

The mean total foveal thickness (in microns) was 287 ± 26 for the ROP-risk group, 276 ± 19 for the preterm group, and 263 ± 20 for the control group (F = 26, p < 0.001). Foveal thickness of the ROP-risk group was significantly higher than that of the preterm group and the control group (all p < 0.05). Foveal thickness was thinner in black children than in white children and thinner in females than in males (all p < 0.001). A similar disparity in race and sex was found in the thickness of the inner and outer layers.

Conclusions

The fovea was significantly thicker in the ROP-risk group than the control group. Foveal thickness decreases with increased gestational age. Race and sex are significant factors in foveal structure in children.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1
Fig. 2
Fig. 3

Similar content being viewed by others

Data availability

Available upon request from the corresponding author.

Code availability

Not applicable.

References

  1. Wang J, Spencer R, Leffler JN (2012) Birch EE (2012) Critical period for foveal fine structure in children with regressed retinopathy of prematurity. Retina 32:330–339. https://doi.org/10.1097/IAE.0b013e318219e685

    Article  CAS  PubMed  Google Scholar 

  2. Rosen R, Sjostrand J, Nilsson M, Hellgren K (2015) A methodological approach for evaluation of foveal immaturity after extremely preterm birth. Ophthalmic Physiol Opt 35:433–441. https://doi.org/10.1111/opo.12221

    Article  PubMed  Google Scholar 

  3. Yanni SE, Wang J, Chan M, Carroll J, Farsiu S, Leffler JN, Spencer R, Birch EE (2012) Foveal avascular zone and foveal pit formation after preterm birth. Br J Ophthalmol 96:961–966. https://doi.org/10.1136/bjophthalmol-2012-301612

    Article  PubMed  Google Scholar 

  4. Quinn GE, Barr C, Bremer D, Fellows R, Gong A, Hoffman R, Repka MX, Shepard J, Siatkowski RM, Wade K, Ying GS (2016) Changes in course of retinopathy of prematurity from 1986 to 2013: comparison of three studies in the United States. Ophthalmology 123:1595–1600. https://doi.org/10.1016/j.ophtha.2016.03.026

    Article  PubMed  Google Scholar 

  5. Saunders RA, Donahue ML, Christmann LM, Pakalnis AV, Tung B, Hardy RJ, Phelps DL (1997) Racial variation in retinopathy of prematurity. The Cryotherapy for Retinopathy of Prematurity Cooperative Group. Arch Ophthalmol 115:604–608. https://doi.org/10.1001/archopht.1997.01100150606005

    Article  CAS  PubMed  Google Scholar 

  6. Yang MB, Donovan EF, Wagge JR (2006) Race, gender, and clinical risk index for babies (CRIB) score as predictors of severe retinopathy of prematurity. J AAPOS 10:253–261. https://doi.org/10.1016/j.jaapos.2006.01.004

    Article  PubMed  Google Scholar 

  7. Asefzadeh B, Cavallerano AA, Fisch BM (2007) Racial differences in macular thickness in healthy eyes. Optom Vis Sci 84:941–945. https://doi.org/10.1097/OPX.0b013e318157a6a0

    Article  PubMed  Google Scholar 

  8. Kashani AH, Zimmer-Galler IE, Shah SM, Dustin L, Do DV, Eliott D, Haller JA, Dong Nguyen Q (2010) Retinal thickness analysis by race, gender, and age using Stratus OCT. Am J Ophthalmol 149:496-502.e1. https://doi.org/10.1016/j.ajo.2009.09.025

    Article  PubMed  Google Scholar 

  9. Grover S, Murthy RK, Brar VS, Chalam KV (2009) Normative data for macular thickness by high-definition spectral-domain optical coherence tomography (spectralis). Am J Ophthalmol 148:266–271. https://doi.org/10.1016/j.ajo.2009.03.006

    Article  PubMed  Google Scholar 

  10. Wagner-Schuman M, Dubis AM, Nordgren RN, Lei Y, Odell D, Chiao H, Weh E, Fischer W, Sulai Y, Dubra A, Carroll J (2011) Racial and gender differences in retinal thickness and foveal pit morphology. Invest Ophthalmol Vis Sci 52:625–634. https://doi.org/10.1167/iovs.10-5886

    Article  PubMed  PubMed Central  Google Scholar 

  11. Kelty PJ, Payne JF, Trivedi RH, Kelty J, Bowie EM, Burger BM (2008) Macular thickness assessment in healthy eyes based on ethnicity using Stratus OCT optical coherence tomography. Invest Ophthalmol Vis Sci 49:2668–2672. https://doi.org/10.1167/iovs.07-1000

    Article  PubMed  Google Scholar 

  12. Pilat AV, Proudlock FA, Mohammad S, Gottlob I (2014) Normal macular structure measured with optical coherence tomography across ethnicity. Br J Ophthalmol 98:941–945. https://doi.org/10.1136/bjophthalmol-2013-303119

    Article  PubMed  Google Scholar 

  13. Hsu ST, Ngo HT, Stinnett SS, Cheung NL, House RJ, Kelly MP, Chen X, Enyedi LB, Prakalapakorn SG, Materin MA, El-Dairi MA, Jaffe GJ, Freeman SF, Toth CA, Vajzovic L (2019) Assessment of macular microvasculature in healthy eyes of infants and children using OCT angiography. Ophthalmology 126:1703–1711. https://doi.org/10.1016/j.ophtha.2019.06.028

    Article  PubMed  Google Scholar 

  14. Hendrickson A, Possin D, Vajzovic L, Toth CA (2012) Histologic development of the human fovea from midgestation to maturity. Am J Ophthalmol 154:767-778.e2. https://doi.org/10.1016/j.ajo.2012.05.007

    Article  PubMed  PubMed Central  Google Scholar 

  15. Hendrickson AE, Yuodelis C (1984) The morphological development of the human fovea. Ophthalmology 91:603–612. https://doi.org/10.1016/s0161-6420(84)34247-6

    Article  CAS  PubMed  Google Scholar 

  16. Duke-Elder S (1963) System ophthalmology. Mosby, St. Louis

    Google Scholar 

  17. Recchia FM, Carvalho-Recchia CA, Trese MT (2002) Optical coherence tomography in the diagnosis of foveal hypoplasia. Arch Ophthalmol 120:1587–1588

    PubMed  Google Scholar 

  18. Hsu ST, Ngo HT, Stinnett SS, Cheung NL, House RJ, Kelly MP, Chen X, Enyedi LB, Prakalapakorn SG, Materin MA, El-Dairi MA, Jaffe GJ, Freeman SF, Toth CA, Vajzovic L (2019) Assessment of macular microvasculature in healthy eyes in infants and children using OCT angiography. Ophthalmology 126:1703–1711

    Article  Google Scholar 

  19. El-Dairi MA, Asrani SG, Enyedi LB, Freedman SF (2009) Optical coherence tomography in the eyes of normal children. Arch Ophthalmol 127:50–58. https://doi.org/10.1001/archophthalmol.2008.553

    Article  PubMed  Google Scholar 

  20. Noval S, Freedman SF, Asrani S, El-Dairi MA (2014) Incidence of fovea plana in normal children. J AAPOS 18:471–475. https://doi.org/10.1016/j.jaapos.2014.07.157

    Article  PubMed  Google Scholar 

  21. Barrio-Barrio J, Noval S, Galdos M, Ruiz-Canela M, Bonet E, Capote M, Lopez M (2013) Multicenter Spanish study of spectral-domain optical coherence tomography in normal children. ActaOphthalmol 91:e56–e63. https://doi.org/10.1111/j.1755-3768.2012.02562.x

    Article  Google Scholar 

  22. Elia N, Pueyo V, Altemir I, Oros D, Pablo LE (2012) Normal reference ranges of optical coherence tomography parameters in childhood. Br J Ophthalmol 96:665–670. https://doi.org/10.1136/bjophthalmol-2011-300916

    Article  PubMed  Google Scholar 

  23. Moreno TA, O’Connell RV, Chiu SJ, Farsiu S, Cabrera MT, Maldonado RS, Tran-Viet D, Freedman SF, Wallace DK, Toth CA (2013) Choroid development and feasibility of choroidal imaging in the preterm and term infants utilizing SD-OCT. Invest Ophthalmol Vis Sci 54:4140–4147. https://doi.org/10.1167/iovs.12-11471

    Article  PubMed  PubMed Central  Google Scholar 

  24. Odell D, Dubis AM, Lever JF, Stepien KE, Carroll J (2011) Assessing errors inherent in OCT-derived macular thickness maps. J Ophthalmol 2011:692574. https://doi.org/10.1155/2011/692574

    Article  PubMed  PubMed Central  Google Scholar 

Download references

Acknowledgements

The authors thank Kim Eissmann for editing the text and thank the reviewers for their invaluable critiques and suggestions to improve the manuscript.

Funding

This work is supported by grants from the National Eye Institute (EY026664), the Pennsylvania Lions Sight Conservation and Eye Research Foundation Grant and by an Institutional Development Award (IDeA) under grant number U54-GM104941 and an award number P20GM13446 from the National Institute of General Medical Sciences of the National Institutes of Health.

Author information

Authors and Affiliations

  1. Department of Pediatric Ophthalmology, Nemours/Alfred I. duPont Hospital for Children, P.O. Box 296, Wilmington, DE, 19899, USA

    Jing Jin, Amanda Friess, Dorothy Hendricks, Sharon Lehman & Jonathan Salvin

  2. Department of Pediatric Ophthalmology, Children’s Hospital of Philadelphia, Philadelphia, PA, USA

    Julia E. Reid

  3. Department of Biological and Vision Sciences, State University of New York College of Optometry, New York, NY, USA

    Jingyun Wang

Authors
  1. Jing Jin
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Amanda Friess
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Dorothy Hendricks
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Sharon Lehman
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. Jonathan Salvin
    View author publications

    You can also search for this author in PubMed Google Scholar

  6. Julia E. Reid
    View author publications

    You can also search for this author in PubMed Google Scholar

  7. Jingyun Wang
    View author publications

    You can also search for this author in PubMed Google Scholar

Contributions

Jing Jin made substantial contributions to the conceptualization, methodology, software, validation, formal analysis, investigation, resources, data curation, writing of the original draft, reviewing and editing, visualization, supervision, project administration, and funding acquisition.

Amanda Friess, Dorothy Hendricks, Sharon Lehman, Jonathan Salvin, and Julia E Reid made substantial contributions to data curation, review and editing of the manuscript, and visualization.

Jingyun Wang made substantial contributions to the conceptualization, methodology, software, formal analysis, investigation, data curation, writing of the original draft, reviewing and editing, visualization, and project administration.

Corresponding author

Correspondence to Jing Jin.

Ethics declarations

Ethics approval

This study was approved by the Institutional Review Board of the Nemours Office of Human Subject Protection and conformed to the requirements of the United States Health Insurance Portability and Privacy Act.

Consent to participate

Not applicable.

Consent for publication

Not applicable.

Competing interests

The authors declare no competing interests.

Additional information

Publisher's note

Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

Dr. Amanda Friess and Dr. Jonathan Salvin have left Nemours/Alfred I. duPont Hospital for Children.

Supplementary Information

Below is the link to the electronic supplementary material.

Supplementary file1 (DOCX 18 KB)

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Jin, J., Friess, A., Hendricks, D. et al. Effect of gestational age at birth, sex, and race on foveal structure in children. Graefes Arch Clin Exp Ophthalmol 259, 3137–3148 (2021). https://doi.org/10.1007/s00417-021-05191-3

Download citation

  • Received:

  • Revised:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s00417-021-05191-3

Keywords

Search

Navigation