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Premature birth associated with lifelong changes in retinal structure and vascularity

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Key Takeaways

  • Premature birth is linked to persistent macular structural and vascular changes in adulthood, even without ROP treatment.
  • OCTA scans revealed decreased FAZ area, circularity, and capillary plexus vessel density in prematurely born adults.
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The investigators found that the premature births to be associated with vascular changes on ocular coherence tomography-angiography.

(Image Credit: AdobeStock/JAKAWAN)

(Image Credit: AdobeStock/JAKAWAN)

Investigators from the Cleveland Clinic Cole Eye Institute, Cleveland, reported the results of a study that identified macular structural and vascularity changes in adults who had been born prematurely,1 according to first author Jacob T. Cox, MD, MPhil.

Cox and colleagues reported these results after conducting a retrospective review of adults who were patients at the Cleveland Clinic from July 2018 to November 2020. All patients had been born prematurely but did not need to be treated for retinopathy of prematurity (ROP); the study also included a group of healthy controls.

The investigators explained that they analyzed swept-source ocular coherence tomography-angiography (OCTA) scans to identify various parameters related to the macular structure and vascularity.

The study included 34 eyes of 21 participants, ie, 17 eyes of 10 patients born prematurely and 17 eyes of 11 healthy controls.

The investigators found that the premature births to be associated with vascular changes on OCTA that included a decreased foveal avascular zone (FAZ) area (p = 0.001), decreased FAZ circularity index (p < 0.001), decreased superficial capillary plexus vessel density (p = 0.02), and decreased deep capillary plexus vessel density (p < 0.001).

The structural changes that were associated with premature births were a shallower foveal pit depth (p < 0.001), decreased cube average thickness (p = 0.005), and increased central subfield thickness-to-cube average thickness ratio (p = 0.002).

The investigators commented, “This is the largest published series of OCTA data for premature-birth adults. Even without a history of ROP treatment, premature birth is associated with multiple changes to the macular structure and vascularity that persist into adulthood. These include a smaller, more irregularly shaped FAZ, decreased juxtafoveal vascular density, and a shallower foveal pit.”

Reference
  1. Cox JT, Knapp AN, Chen C, et al. Macular changes in adults with history of premature birth. Retina 2025;45:171-177;doi:10.1097/IAE.0000000000004298
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