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Arch Dis Child Fetal Neonatal Ed. 2017 Nov;102(6):F532-F537. doi: 10.1136/archdischild-2016-312533. Epub 2017 May 23.

Severe retinopathy of prematurity predicts delayed white matter maturation and poorer neurodevelopment.

Author information

1
Department of Pediatrics (Neurology), University of Toronto and the Hospital for Sick Children, Toronto, Canada.
2
Neurosciences & Mental Health, SickKids Research Institute, Toronto, Canada.
3
BC Children's Hospital Research Institute, Vancouver, Canada.
4
Department of Ophthalmology and Vision Science, University of British Columbia and BC Children's Hospital, Vancouver, Canada.
5
Department of Anesthesiology, University of Calgary, Calgary, Canada.
6
Department of Pediatrics (Developmental Pediatrics), University of British Columbia and BC Children's and Women's Hospitals, Vancouver, Canada.
7
Department of Occupational Science and Occupational Therapy, Vancouver, Canada.
8
Sunny Hill Health Centre for Children, Vancouver, Canada.
9
Department of Pediatrics (Neonatology), University of British Columbia and BC Children's and Women's Hospitals, Vancouver, Canada.
10
Department of Radiology, University of British Columbia and BC Children's Hospital, Vancouver, Canada.

Abstract

OBJECTIVE:

To determine whether severe retinopathy of prematurity (ROP) is associated with (1) abnormal white matter maturation and (2) neurodevelopmental outcomes at 18 months' corrected age (CA) compared with neonates without severe ROP.

DESIGN:

We conducted a prospective longitudinal cohort of extremely preterm neonates born 24-28 weeks' gestational age recruited between 2006 and 2013 with brain MRIs obtained both early in life and at term-equivalent age. Severe ROP was defined as ROP treated with retinal laser photocoagulation. Using diffusion tensor imaging and tract-based spatial statistics (TBSS), white matter maturation was assessed by mean fractional anisotropy (FA) in seven predefined regions of interest. Neurodevelopmental outcomes were assessed with Bayley Scales of Infant and Toddler Development-III (Bayley-III) composite scores at 18 months' CA. Subjects were compared using Fisher's exact, Kruskal-Wallis and generalised estimating equations.

SETTING:

Families were recruited from the neonatal intensive care unit at BC Women's Hospital.

PATIENTS:

Of 98 extremely preterm neonates (median: 26.0 weeks) assessed locally for ROP, 19 (19%) had severe ROP and 83 (85%) were assessed at 18 months' CA.

RESULTS:

Severe ROP was associated with lower FA in the posterior white matter, and with decreased measures of brain maturation in the optic radiations, posterior limb of the internal capsule (PLIC) and external capsule on TBSS. Bayley-III cognitive and motor scores were lower in infants with severe ROP.

CONCLUSIONS:

Severe ROP is associated with maturational delay in the optic radiations, PLIC, external capsule and posterior white matter, housing the primary visual and motor pathways, and is associated with poorer cognitive and motor outcomes at 18 months' CA.

KEYWORDS:

diffusion tensor imaging; microstructure; preterm infant; preterm neonate; retinopathy of prematurity; white matter development

[Indexed for MEDLINE]

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