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Fieß A, Schultheis A, Mildenberger E, Urschitz MS, Stoffelns B, Pfeiffer N, Schuster AK. Ocular geometry in adults born small, appropriate or large for gestational age at term. Acta Ophthalmol 2024; 102:e86-e93. [PMID: 37070484 DOI: 10.1111/aos.15672] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/20/2022] [Revised: 03/07/2023] [Accepted: 03/27/2023] [Indexed: 04/19/2023]
Abstract
PURPOSE Intrauterine growth restriction leading to a birth weight (BW) which is too low for gestational age (GA) is a known risk factor for various altered organ morphologies and dysfunction in later life. This study aimed to determine for the first time the effects of being small (SGA) or large for gestational age (LGA) on the ocular geometry of adults born at term. METHODS All participants were examined with optical biometry (LenStar 900, Haag Streit) to compare the corneal curvature, white-to-white distance, anterior chamber depth, lens thickness and axial length between former moderate (BW percentile 3rd to <10th) and severe (BW <3rd percentile) SGA, controls (BW 10th-90th percentile) and former moderate (BW >90th to 97th percentile) and severe (BW >97th percentile) LGA. Multivariable linear regression was used to analyse associations with GA, BW percentile categories, placental insufficiency, preeclampsia and breastfeeding after adjustment for age and sex. RESULTS In total, 589 eyes of 296 individuals born at term (aged 30.0 ± 9.4 years, 156 females) were examined, including 40 severe SGA, 38 moderate SGA, 140 with normal BW, 38 moderate LGA and 40 severe LGA. There was an association between a steeper corneal curvature with moderate (B = -0.201; p < 0.001) and severe SGA (B = -0.199; p < 0.001), with extreme SGA associated with smaller white-to-white (B = -0.263; p = 0.001) and a shorter axial length (B = -0.524; p = 0.031). CONCLUSIONS Severe and moderate prenatal growth restriction in adults born at term leads to an altered ocular geometry, namely a steepening of the cornea and a smaller corneal diameter.
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Affiliation(s)
- Achim Fieß
- Department of Ophthalmology, University Medical Center of the Johannes Gutenberg University Mainz, Mainz, Germany
| | - Anna Schultheis
- Department of Ophthalmology, University Medical Center of the Johannes Gutenberg University Mainz, Mainz, Germany
| | - Eva Mildenberger
- Division of Neonatology, Department of Pediatrics, University Medical Center of the Johannes Gutenberg University Mainz, Germany
| | - Michael S Urschitz
- Division of Pediatric Epidemiology, Institute for Medical Biostatistics, Epidemiology and Informatics, University Medical Center of the Johannes Gutenberg University Mainz, Mainz, Germany
| | - Bernhard Stoffelns
- Department of Ophthalmology, University Medical Center of the Johannes Gutenberg University Mainz, Mainz, Germany
| | - Norbert Pfeiffer
- Department of Ophthalmology, University Medical Center of the Johannes Gutenberg University Mainz, Mainz, Germany
| | - Alexander K Schuster
- Department of Ophthalmology, University Medical Center of the Johannes Gutenberg University Mainz, Mainz, Germany
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Fieß A, Grabitz SD, Mildenberger E, Urschitz MS, Fauer A, Hampel U, Wasielica-Poslednik J, Zepp F, Pfeiffer N, Schuster AK. A lower birth weight percentile is associated with central corneal thickness thinning: Results from the Gutenberg Prematurity Eye Study (GPES). JOURNAL OF OPTOMETRY 2023; 16:143-150. [PMID: 36182657 PMCID: PMC10104790 DOI: 10.1016/j.optom.2022.07.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/27/2022] [Revised: 06/17/2022] [Accepted: 07/03/2022] [Indexed: 06/16/2023]
Abstract
PURPOSE Prematurity, prenatal growth restriction, and retinopathy of prematurity (ROP) are associated with altered ocular geometry, such as a steeper corneal shape in childhood, but it is unclear whether perinatal history affects corneal thickness development, so this study investigated whether corneal thickness in adulthood is affected by perinatal history. MARTERIALS AND METHODS The Gutenberg Prematurity Eye Study (GPES) is a retrospective cohort study with a prospective ophthalmologic examination in Germany. The corneal thickness was measured by Scheimpflug imaging (Pentacam HR, Oculus Optikgeräte GmbH, Wetzlar, Germany), and the relationship between perinatal parameters respective birth weight percentile and corneal thickness at different locations was assessed using uni- and multivariable linear regression models. Covariates included age, sex, mean corneal radius, white-to-white distance, gestational age, birth weight percentile, ROP occurrence, and treatment. The main outcome measures were corneal thickness at the apex, the pupil center, and the corneal periphery. RESULTS The corneal thickness was measured in 390 participants (754 eyes, mean age 29.7+/-8.7 years, 224 females). In multivariable analyses, a lower birth weight percentile was associated with a lower corneal thickness at the apex (B = 0.20, p = 0.003) and the pupil (B = 0.19, p = 0.007). These effects diminished towards the corneal periphery and were not observed beyond the 4-mm diameter circle around the thinnest corneal position. Neither gestational age, ROP occurrence, or ROP treatment affected the corneal thickness. CONCLUSION A lower birth weight percentile in subjects born preterm as a proxy for restricted fetal growth is associated with corneal thickness thinning in adults aged 18 to 52 years, indicating that corneal thickness development, particularly in the corneal center, may originate in the fetal stage.
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Affiliation(s)
- Achim Fieß
- Department of Ophthalmology, University Medical Center of the Johannes Gutenberg University Mainz, Mainz, Germany.
| | - Stephanie D Grabitz
- Department of Ophthalmology, University Medical Center of the Johannes Gutenberg University Mainz, Mainz, Germany
| | - Eva Mildenberger
- Division of Neonatology, Department of Pediatrics, University Medical Center of the Johannes Gutenberg University Mainz, Germany
| | - Michael S Urschitz
- Division of Pediatric Epidemiology, Institute for Medical Biostatistics, Epidemiology and Informatics, University Medical Center of the Johannes Gutenberg University Mainz, Mainz, Germany
| | - Agnes Fauer
- Department of Ophthalmology, University Medical Center of the Johannes Gutenberg University Mainz, Mainz, Germany
| | - Ulrike Hampel
- Department of Ophthalmology, University Hospital Leipzig, Leipzig, Germany
| | - Joanna Wasielica-Poslednik
- Department of Ophthalmology, University Medical Center of the Johannes Gutenberg University Mainz, Mainz, Germany
| | - Fred Zepp
- Division of Neonatology, Department of Pediatrics, University Medical Center of the Johannes Gutenberg University Mainz, Germany
| | - Norbert Pfeiffer
- Department of Ophthalmology, University Medical Center of the Johannes Gutenberg University Mainz, Mainz, Germany
| | - Alexander K Schuster
- Department of Ophthalmology, University Medical Center of the Johannes Gutenberg University Mainz, Mainz, Germany
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Fieß A, Urschitz MS, Nagler M, Nickels S, Marx-Groß S, Münzel T, Wild PS, Beutel ME, Lackner KJ, Pfeiffer N, Schuster AK. Association of birth weight with corneal aberrations in adulthood - Results from a population-based study. JOURNAL OF OPTOMETRY 2023; 16:42-52. [PMID: 35764478 PMCID: PMC9811361 DOI: 10.1016/j.optom.2021.06.004] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/18/2021] [Revised: 05/21/2021] [Accepted: 06/27/2021] [Indexed: 06/13/2023]
Abstract
PURPOSE Low birth weight (BW) is associated with increased corneal aberrations in childhood and alterations of corneal geometry in adulthood. Increased corneal aberrations may be a factor contributing to decreased visual function in former low BW newborns in later life. Hence, the aim of this study was to analyze the long-term effect of low BW on corneal aberrations in adulthood. METHODS In the German population-based Gutenberg Health Study (GHS) participants (age: 40-80 years) were examined with Scheimpflug imaging (Pentacam HR, Oculus Optikgeräte GmbH, Wetzlar, Germany). The relationship between self-reported BW and the different types of corneal aberrations was analyzed using linear regression analysis as uni- and multivariable analysis with adjustment for potential confounders. The main outcome measures were corneal aberrations defined as astigmatism (Z2-2; Z22), coma (Z3-1; Z31), trefoil (Z3-3; Z33), spherical aberration (Z40) and root-mean square of higher order aberrations (HOA; 3rd up to 8th order; aperture size: 6 mm). RESULTS Overall, 5,628 participants were included in this analysis (3,004 women, aged 56.0 +/- 10.3 years). In a multivariable analysis lower BW was associated with decreased horizontal trefoil (B = 0.004 [0.001; 0.006] µm/500 g; p=.008); higher spherical aberrations (B=-0.006 [-0.008;-0.003] µm/500 g; p<.001), higher RMS (B=-0.028 [-0.042;-0.014] µm/500 g; p<.001), increased HOA (B=-0.007 [-0.010;-0.003] µm/500 g; p<.001) and increased LOA (B=-0.027 [-0.041;-0.013] µm/500 g; p<.001). No association was observed between birth weight and the other types of corneal aberrations in multivariable model. CONCLUSION Our results indicate an association between BW and spherical aberration in adults aged 40 to 80 years. This indicates that low BW may have an association with an altered corneal shape development which may affect optical image quality and, hence, visual function.
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Affiliation(s)
- Achim Fieß
- Department of Ophthalmology, University Medical Center of the Johannes Gutenberg University Mainz, Mainz, Germany.
| | - Michael S Urschitz
- Division of Pediatric Epidemiology, Institute for Medical Biostatistics, Epidemiology and Informatics, University Medical Center of the Johannes Gutenberg University Mainz, Mainz, Germany
| | - Markus Nagler
- Preventive Cardiology and Preventive Medicine / Center for Cardiology, University Medical Center of the Johannes Gutenberg University Mainz, Mainz, Germany
| | - Stefan Nickels
- Department of Ophthalmology, University Medical Center of the Johannes Gutenberg University Mainz, Mainz, Germany
| | - Susanne Marx-Groß
- Department of Ophthalmology, University Medical Center of the Johannes Gutenberg University Mainz, Mainz, Germany
| | - Thomas Münzel
- Center for Cardiology - Cardiology I, University Medical Center of the Johannes Gutenberg University Mainz, Mainz, Germany
| | - Philipp S Wild
- Preventive Cardiology and Preventive Medicine / Center for Cardiology, University Medical Center of the Johannes Gutenberg University Mainz, Mainz, Germany; Center for Thrombosis and Hemostasis (CTH), University Medical Center of the Johannes Gutenberg University Mainz, Mainz, Germany; German Center for Cardiovascular Research (DZHK), partner site Rhine-Main, Mainz, Germany
| | - Manfred E Beutel
- Department of Psychosomatic Medicine and Psychotherapy, University Medical Center of the Johannes Gutenberg University Mainz, Mainz, Germany
| | - Karl J Lackner
- Institute of Clinical Chemistry and Laboratory Medicine, University Medical Center of the Johannes Gutenberg University Mainz, Mainz, Germany
| | - Norbert Pfeiffer
- Department of Ophthalmology, University Medical Center of the Johannes Gutenberg University Mainz, Mainz, Germany
| | - Alexander K Schuster
- Department of Ophthalmology, University Medical Center of the Johannes Gutenberg University Mainz, Mainz, Germany
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Corneal Aberrations and Thickness in Adults Born Small, Appropriate, or Large for Gestational Age at Term. J Clin Med 2022; 11:jcm11236903. [PMID: 36498478 PMCID: PMC9740638 DOI: 10.3390/jcm11236903] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/14/2022] [Revised: 11/17/2022] [Accepted: 11/18/2022] [Indexed: 11/24/2022] Open
Abstract
Background/Aims: This study investigated whether there are changes in corneal surface regularity and corneal thickness in adults born small, appropriate, or large for gestational age at term. Methods: This retrospective cohort study involved prospective Scheimpflug imaging of the cornea (Pentacam®) to compare the corneal thickness and aberrations between adults classified as small for gestational age (SGA), normal birth weight (BW), and large for gestational age (LGA). Multivariable linear regression was applied to analyze associations with gestational age, BW percentile, placental insufficiency, preeclampsia, and breastfeeding. Results: In total, 448 eyes of 261 individuals born full term (aged 29.9 ± 9.5 years, 140 females) were examined, including 29 severe SGA (BW < 3rd percentile), 32 moderate SGA (BW between 3rd and <10th percentile), 132 normal BW (BW between 10th and 90th percentile), 35 moderate LGA (BW between >90th and 97th percentile), and 33 severe LGA (BW > 97th percentile). There were no differences between groups in the corneal aberrations of the total cornea as well as of the corneal front surface, except for higher-order aberrations in the front of the cornea (p = 0.032). There was an association between the increased total root mean square of higher-order aberrations and lower birth weight percentile (p = 0.004), with increased higher-order aberrations correlating with lower visual acuity and spherical equivalent. Conclusion: Restricted prenatal growth is associated with increased higher-order aberrations in adulthood.
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Fieß A, Berger LA, Riedl JC, Mildenberger E, Urschitz MS, Hampel U, Wasielica-Poslednik J, Zepp F, Stoffelns B, Pfeiffer N, Schuster AK. The role of preterm birth, retinopathy of prematurity and perinatal factors on corneal aberrations in adulthood: Results from the Gutenberg prematurity eye study. Ophthalmic Physiol Opt 2022; 42:1379-1389. [PMID: 36006775 DOI: 10.1111/opo.13038] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/15/2022] [Revised: 06/18/2022] [Accepted: 07/19/2022] [Indexed: 12/11/2022]
Abstract
INTRODUCTION Prematurity and retinopathy of prematurity (ROP) are associated with altered corneal shape and reduced visual acuity in childhood, but their long-term effects on corneal shape in later life are still unclear. This study evaluated whether prematurity and related perinatal factors are associated with corneal aberrations in adulthood. METHODS The Gutenberg Prematurity Eye Study (GPES) is a cohort study using Scheimpflug imaging of the cornea. Associations were assessed between corneal Zernike aberrations and gestational age (GA), birth weight (BW), BW percentile, ROP occurrence, ROP treatment and other perinatal factors using univariate and multivariable linear regression analyses. RESULTS This study involved 444 eyes of 256 individuals born preterm (aged 28.1 ± 8.4 years, 146 females) and 231 eyes of 132 individuals born full-term (aged 29.8 ± 8.9 years, 77 females). Multivariable analyses revealed an association between corneal higher-order aberrations and lower birth weight percentile (B = -0.001, p < 0.001) as well as ROP treatment (B = 0.120, p = 0.03). Corneal lower-order aberrations were also associated with lower birth weight percentile (B = -0.004; p = 0.001) and ROP treatment (B = 0.838, p = 0.01) but not with ROP occurrence. Increased corneal aberrations were correlated with lower visual acuity and the spherical equivalent refractive error. CONCLUSIONS Perinatal factors, particularly low birth weight percentile and ROP treatment lead to a more irregular corneal shape in adulthood, thereby reducing optical image quality and potentially contributing to reduced visual acuity and altered refractive error.
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Affiliation(s)
- Achim Fieß
- Department of Ophthalmology, University Medical Center of the Johannes Gutenberg University Mainz, Mainz, Germany
| | - Lina Amalia Berger
- Department of Ophthalmology, University Medical Center of the Johannes Gutenberg University Mainz, Mainz, Germany
| | - Jana C Riedl
- Department of Ophthalmology, University Medical Center of the Johannes Gutenberg University Mainz, Mainz, Germany
| | - Eva Mildenberger
- Division of Neonatology, Department of Pediatrics, University Medical Center of the Johannes Gutenberg University Mainz, Mainz, Germany
| | - Michael S Urschitz
- Division of Pediatric Epidemiology, Institute for Medical Biostatistics, Epidemiology and Informatics, University Medical Center of the Johannes Gutenberg University Mainz, Mainz, Germany
| | - Ulrike Hampel
- Department of Ophthalmology, University Hospital Leipzig, Leipzig, Germany
| | - Joanna Wasielica-Poslednik
- Department of Ophthalmology, University Medical Center of the Johannes Gutenberg University Mainz, Mainz, Germany
| | - Fred Zepp
- Division of Neonatology, Department of Pediatrics, University Medical Center of the Johannes Gutenberg University Mainz, Mainz, Germany
| | - Bernhard Stoffelns
- Department of Ophthalmology, University Medical Center of the Johannes Gutenberg University Mainz, Mainz, Germany
| | - Norbert Pfeiffer
- Department of Ophthalmology, University Medical Center of the Johannes Gutenberg University Mainz, Mainz, Germany
| | - Alexander K Schuster
- Department of Ophthalmology, University Medical Center of the Johannes Gutenberg University Mainz, Mainz, Germany
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Fieß A, Nauen H, Mildenberger E, Zepp F, Urschitz MS, Pfeiffer N, Schuster AKG. Ocular geometry in adults born extremely, very and moderately preterm with and without retinopathy of prematurity: results from the Gutenberg Prematurity Eye Study. Br J Ophthalmol 2022:bjophthalmol-2021-320907. [PMID: 35273019 PMCID: PMC10359553 DOI: 10.1136/bjophthalmol-2021-320907] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/06/2021] [Accepted: 02/20/2022] [Indexed: 11/04/2022]
Abstract
BACKGROUND/AIMS To evaluate whether anterior segment anatomy and axial length are associated with prematurity and perinatal factors in adults. METHODS The Gutenberg Prematurity Eye Study examined adults born preterm and term aged 18-52 years. All participants underwent a prospective ophthalmic examination (optical biometry via a LenStar 900, Haag-Streit) in Germany. The associations between gestational age (GA), birth weight (BW) and BW percentile, retinopathy of prematurity (ROP) occurrence, ROP treatment and other perinatal factors with the main outcome measures were evaluated by univariate and multivariable linear regression analyses. Main outcome measures were corneal radius, white-to-white distance, anterior chamber depth, lens thickness and axial length. RESULTS The study involved 861 eyes of 438 preterm and full-term individuals (aged 28.6±8.7 years, 245 females,). After adjustment for age and gender, a steeper corneal radius was associated with lower GA (B=0.02; p<0.001) and a lower BW percentile (B=0.003; p<0.001). A smaller white-to-white distance was linked to lower GA (B=0.02; p<0.001), a lower BW percentile (B=0.004; p<0.001) and postnatal ROP occurrence (B=-0.26; p<0.001). Decreased axial length was associated with lower GA at birth (B=0.05; p=0.002) and pre-eclampsia (B=-0.34; p=0.015). ROP-treated eyes had a shallower anterior chamber depth (B=-0.63; p=0.001) and increased lens thickness (B=0.64, p<0.001). CONCLUSION Our analyses in adults demonstrate that the corneal morphology is influenced by GA and BW percentile, while the anterior chamber depth and lens thickness are affected by ROP treatment, namely laser therapy and cryotherapy. The present study highlights that perinatal factors lead to lifelong sequelae of ocular shape.
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Affiliation(s)
- Achim Fieß
- Department of Ophthalmology, University Medical Center of the Johannes Gutenberg University Mainz, Mainz, Germany
| | - Hannah Nauen
- Department of Ophthalmology, University Medical Center of the Johannes Gutenberg University Mainz, Mainz, Germany
| | - Eva Mildenberger
- Department of Pediatrics, University Medical Center of the Johannes Gutenberg-University Mainz, Mainz, Germany
| | - Fred Zepp
- Department of Pediatrics, University Medical Center of the Johannes Gutenberg-University Mainz, Mainz, Germany
| | - Michael S Urschitz
- Division of Pediatric Epidemiology, Institute for Medical Biostatistics, Epidemiology and Informatics, University Medical Center of the Johannes Gutenberg University Mainz, Mainz, Germany
| | - Norbert Pfeiffer
- Department of Ophthalmology, University Medical Center of the Johannes Gutenberg University Mainz, Mainz, Germany
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Fieß A, Gißler S, Mildenberger E, Urschitz MS, Fauer A, Elflein HM, Zepp F, Stoffelns B, Pfeiffer N, Schuster AK. Anterior Chamber Angle in Adults Born Extremely, Very, and Moderately Preterm with and without Retinopathy of Prematurity-Results of the Gutenberg Prematurity Eye Study. CHILDREN (BASEL, SWITZERLAND) 2022; 9:children9020281. [PMID: 35205001 PMCID: PMC8869987 DOI: 10.3390/children9020281] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/11/2022] [Revised: 02/05/2022] [Accepted: 02/14/2022] [Indexed: 11/18/2022]
Abstract
Purpose: To determine whether prematurity and associated factors affect the anterior chamber angle (ACA) width in adulthood. Methods: The Gutenberg Prematurity Eye Study (GPES) is a retrospective cohort study with a prospective ophthalmologic examination of adults (age 18–52 years) in Germany. All participants were examined with Scheimpflug imaging (Pentacam HR, Oculus Optikgeräte GmbH, Wetzlar, Germany) using linear regression analysis to assess the associations of ACA in the different sectors with gestational age (GA), birth weight, birth weight percentile, retinopathy of prematurity (ROP), ROP treatment, placental insufficiency, preeclampsia, and breastfeeding. Results: In total, 516 eyes of 319 preterm and full-term individuals (aged 28.9 ± 8.8 years, 188 females) were examined. ROP treatment was associated with smaller ACA width in the nasal (B = −9.6 [95%CI: −14.7; −4.5] degree; p < 0.001) and temporal positions (B = −11.5 [95%CI: −17.7; −5.3] degree; p = 0.001), whereas non-treated individuals with ROP had an unaltered ACA width, as did individuals with low gestational age without ROP. Conclusion: Advanced stages of ROP following treatment with laser- and cryocoagulation lead to a smaller ACA width until adulthood, and hence may increase the risk of angle closure in later life.
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Affiliation(s)
- Achim Fieß
- Department of Ophthalmology, University Medical Center of the Johannes Gutenberg University Mainz, 55131 Mainz, Germany; (S.G.); (A.F.); (H.M.E.); (B.S.); (N.P.); (A.K.S.)
- Correspondence: ; Tel.: +49-(0)-6131-17-5150; Fax: +49-(0)-6131-17-8495
| | - Sandra Gißler
- Department of Ophthalmology, University Medical Center of the Johannes Gutenberg University Mainz, 55131 Mainz, Germany; (S.G.); (A.F.); (H.M.E.); (B.S.); (N.P.); (A.K.S.)
| | - Eva Mildenberger
- Division of Neonatology, Department of Pediatrics, University Medical Center of the Johannes Gutenberg University Mainz, 55131 Mainz, Germany; (E.M.); (F.Z.)
| | - Michael S. Urschitz
- Division of Pediatric Epidemiology, Institute for Medical Biostatistics, Epidemiology and Informatics, University Medical Center of the Johannes Gutenberg University Mainz, 55131 Mainz, Germany;
| | - Agnes Fauer
- Department of Ophthalmology, University Medical Center of the Johannes Gutenberg University Mainz, 55131 Mainz, Germany; (S.G.); (A.F.); (H.M.E.); (B.S.); (N.P.); (A.K.S.)
| | - Heike M. Elflein
- Department of Ophthalmology, University Medical Center of the Johannes Gutenberg University Mainz, 55131 Mainz, Germany; (S.G.); (A.F.); (H.M.E.); (B.S.); (N.P.); (A.K.S.)
| | - Fred Zepp
- Division of Neonatology, Department of Pediatrics, University Medical Center of the Johannes Gutenberg University Mainz, 55131 Mainz, Germany; (E.M.); (F.Z.)
| | - Bernhard Stoffelns
- Department of Ophthalmology, University Medical Center of the Johannes Gutenberg University Mainz, 55131 Mainz, Germany; (S.G.); (A.F.); (H.M.E.); (B.S.); (N.P.); (A.K.S.)
| | - Norbert Pfeiffer
- Department of Ophthalmology, University Medical Center of the Johannes Gutenberg University Mainz, 55131 Mainz, Germany; (S.G.); (A.F.); (H.M.E.); (B.S.); (N.P.); (A.K.S.)
| | - Alexander K. Schuster
- Department of Ophthalmology, University Medical Center of the Johannes Gutenberg University Mainz, 55131 Mainz, Germany; (S.G.); (A.F.); (H.M.E.); (B.S.); (N.P.); (A.K.S.)
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Association of Birth Weight with Central and Peripheral Corneal Thickness in Adulthood-Results from the Population-Based German Gutenberg Health Study. CHILDREN (BASEL, SWITZERLAND) 2021; 8:children8111006. [PMID: 34828719 PMCID: PMC8625912 DOI: 10.3390/children8111006] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 09/17/2021] [Revised: 10/27/2021] [Accepted: 10/31/2021] [Indexed: 12/26/2022]
Abstract
Purpose: Low birth weight (BW) is associated with altered ocular geometry such as a steeper corneal shape in adulthood. However, it is unclear whether low birth weight affects corneal thickness development in the center or periphery in adulthood which may contribute to ocular disease. The purpose of this study was to investigate corneal thickness in former low birth weight individuals in adulthood. Methods: The German Gutenberg Health Study is a prospective, population-based study in which every participant (age range 40–80 years) was measured with Scheimpflug imaging (Pentacam HR, Oculus Optikgeräte GmbH, Wetzlar, Germany). BW was collected by self-reports. The relationship between birth weight and corneal thickness at different locations were assessed. Linear regression models were carried out including uni- and multivariable analyses with adjustment for age, sex, mean corneal radius, and white-to-white distance. Main outcome measures were corneal thickness at the apex, at the pupil center, and at the corneal periphery. Results: Overall, 5657 participants were successfully measured (3019 females, aged 56.0 ± 10.3 years). In multivariable analyses a lower BW was associated with a thinner corneal thickness at the apex (B = 1.71 µm/500 g, p < 0.001) and at the pupil (B = 1.69 µm/500 g, p < 0.001). These effects diminished towards the corneal periphery resulting in no differences in the perilimbal regions. Conclusion: The present study provides evidence that lower birth weight goes along with corneal thickness alterations even into adult ages of 40 to 80 years. Thinner measurements of the cornea were particularly found in the corneal center and diminished in the periphery. This indicates that there may be fetal origins affecting corneal thickness development particularly in the corneal center.
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Microcornea and Thickened Lens in Angle Closure following Nonsurgical Treatment of Retinopathy of Prematurity. J Ophthalmol 2020; 2020:7510903. [PMID: 32454993 PMCID: PMC7225864 DOI: 10.1155/2020/7510903] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/29/2019] [Revised: 04/01/2020] [Accepted: 04/11/2020] [Indexed: 12/26/2022] Open
Abstract
Purpose To characterize the clinical features in young patients with angle closure and to determine the characteristics associated with acquired anterior segment abnormality following retinopathy of prematurity (ROP) treatment. Methods We performed two retrospective case-control series. In the first series, we identified consecutive young angle closure patients without prior surgeries, with and without a history of ROP treatment; in the second series we identified consecutive patients who underwent ROP treatment, without and without anterior segment changes. Results In the first series, 25 eyes of 14 consecutive angle closure patients were included: 19 eyes (11 patients, 78.6%) had a history of treated ROP, while 6 eyes (3 patients) belonged to full-term patients. The treated ROP eyes had significantly shallower anterior chambers (1.77 ± 0.17 mm vs 2.72 ± 0.18 mm, P < 0.0001) and thicker lenses (5.20 ± 0.54 mm vs 3.98 ± 0.20 mm, P = 0.0002) compared to the full-term controls. In the second series, 79 eyes of 40 patients were included, with median gestational age of 24.6 weeks. Acquired iridocorneal adhesion was noted in the eight eyes (10.1%) at a mean age of 4.7 years and was associated with prior zone 1 and plus disease (P = 0.0013), a history of initial intravitreal bevacizumab treatment (IVB, P = 0.0477) and a history of requiring additional IVB after initial treatment (P = 0.0337). Conclusions Many young angle closure patients may have a history of treated ROP and may present with the triad of increased lens thickness, microcornea, and angle closure.
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Fieß A, Schuster AK, Nickels S, Urschitz MS, Elflein HM, Schulz A, Münzel T, Wild PS, Beutel ME, Schmidtmann I, Lackner KJ, Pfeiffer N. Association of Low Birth Weight With Altered Corneal Geometry and Axial Length in Adulthood in the German Gutenberg Health Study. JAMA Ophthalmol 2020; 137:507-514. [PMID: 30789653 DOI: 10.1001/jamaophthalmol.2018.7121] [Citation(s) in RCA: 28] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022]
Abstract
Importance Low birth weight is associated with altered ocular organ development in childhood, including the morphology of the eye. However, no population-based data exist about this association in adulthood. Objective To evaluate whether low birth weight has a long-term association with anterior segment anatomy and axial length in adulthood. Design, Setting, and Participants The Gutenberg Health Study is a population-based, observational cohort study in Germany. All participants underwent ocular biometry. Among the participants with follow-up and self-reported birth weight available, associations were assessed between low birth weight and anterior segment anatomy and axial length using multivariable linear regression analysis with adjustment for age and sex. In patients with phakia, anterior chamber depth and lens thickness were also examined. Data for this study were collected from April 27, 2012, through April 28, 2017, and analyzed from January through April 2018. Exposures Low birth weight. Main Outcomes and Measures Corneal curvature, central corneal thickness, white-to-white distance, anterior chamber depth, lens thickness, and axial length. Results Overall, 11 294 eyes of 7120 participants were included (52.4% female; mean [SD] age, 56.2 [10.3] years). Most of the participants were white (98.6%). After adjustment for age and sex, an association was found between a lower birth weight and steeper corneal curvature (β = 0.005 mm/100 g; 95% CI, 0.005-0.006 mm/100 g; P < .001), smaller white-to-white distance (β = 0.006 mm/100 g; 95% CI, 0.005-0.007 mm/100 g; P < .001), thinner central corneal thickness (β = 0.327 μm/100 g; 95% CI, 0.229-0.425 μm/100 g; P < .001), and shorter axial length (β = 0.006 mm/100 g; 95% CI, 0.003-0.010 mm/100 g; P < .001). However, anterior chamber depth and lens thickness were not associated with low birth weight in participants with phakia (10 510 eyes of 5279 participants). Conclusions and Relevance These analyses demonstrate an association between low birth weight and altered ocular geometry in adults aged 40 to 80 years, suggesting that birth weight and associated factors are crucial in anatomical ocular morphologic development. Retinopathy of prematurity and its treatment may affect ocular anatomy but could not be further analyzed in this study.
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Affiliation(s)
- Achim Fieß
- Department of Ophthalmology, University Medical Center, Johannes Gutenberg University Mainz, Mainz, Germany
| | - Alexander K Schuster
- Department of Ophthalmology, University Medical Center, Johannes Gutenberg University Mainz, Mainz, Germany
| | - Stefan Nickels
- Department of Ophthalmology, University Medical Center, Johannes Gutenberg University Mainz, Mainz, Germany
| | - Michael S Urschitz
- Division of Pediatric Epidemiology, Institute for Medical Biostatistics, Epidemiology and Informatics, University Medical Center, Johannes Gutenberg University Mainz, Mainz, Germany
| | - Heike M Elflein
- Department of Ophthalmology, University Medical Center, Johannes Gutenberg University Mainz, Mainz, Germany
| | - Andreas Schulz
- Preventive Cardiology and Preventive Medicine, Center for Cardiology, University Medical Center, Johannes Gutenberg University Mainz, Mainz, Germany
| | - Thomas Münzel
- Center for Cardiology-Cardiology I, University Medical Center, Johannes Gutenberg University Mainz, Mainz, Germany
| | - Philipp S Wild
- Preventive Cardiology and Preventive Medicine, Center for Cardiology, University Medical Center, Johannes Gutenberg University Mainz, Mainz, Germany.,Center for Thrombosis and Hemostasis, University Medical Center, Johannes Gutenberg University Mainz, Mainz, Germany.,German Center for Cardiovascular Research, Rhine-Main Partner Site, Mainz, Germany
| | - Manfred E Beutel
- Department of Psychosomatic Medicine and Psychotherapy, University Medical Center, Johannes Gutenberg University Mainz, Mainz, Germany
| | - Irene Schmidtmann
- Division of Biostatistics and Bioinformatics, Institute for Medical Biostatistics, Epidemiology and Informatics, University Medical Center, Johannes Gutenberg University Mainz, Mainz, Germany
| | - Karl J Lackner
- Institute of Clinical Chemistry and Laboratory Medicine, University Medical Center, Johannes Gutenberg University Mainz, Mainz, Germany
| | - Norbert Pfeiffer
- Department of Ophthalmology, University Medical Center, Johannes Gutenberg University Mainz, Mainz, Germany
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Lai YH, Chen HL, Yang SN, Chang SJ, Chuang LY, Wu WC. The characteristics of premature infants with transient corneal haze. PLoS One 2018; 13:e0195300. [PMID: 29596534 PMCID: PMC5875869 DOI: 10.1371/journal.pone.0195300] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/02/2017] [Accepted: 03/15/2018] [Indexed: 12/01/2022] Open
Abstract
Background The etiology of transient corneal haze in premature infants is not known and how it relates to clinical outcomes in premature infants is not clear. Objectives To study associated factors of transient corneal haze in premature infants. Methods We performed a retrospective study of 261 premature infants from retinopathy of prematurity (ROP) screening in the neonatal intensive care unit at a tertiary referral hospital. Characteristics of premature infants with and without corneal haze were analyzed by correlation tests, Chi-square tests, and logistic regressions were used for statistical analyses. Associations between corneal haze and birth weight (BW), gestational age at birth (GA), central corneal thickness, intraocular pressure, and other systemic and ophthalmic data were evaluated. Results The incidence of corneal haze was 13.4%. Lower BW, lower GA, packed red blood cells (RBC) transfusion, more days on oxygen, older maternal age, bronchopulmonary disease, and stage 3 ROP are associated with corneal haze. The severity of corneal haze decreased with infants’ postmenstrual age. Multivariate logistic regression analyses revealed that BW and maternal age are the most important predictors of corneal haze. Conclusion Low BW and older maternal age are the most important predictors of corneal haze in premature infants. Premature infants with corneal haze could carry more systemic and ocular morbidities. Hence they may require more clinical attention. Corneal haze is unlikely to hinder the treatment of ROP. However, it is possible that corneal haze could hinder the examination of ROP in some infants. If corneal haze does interfere with ROP screening, a closer, more conservative follow-up schedule with a senior ophthalmologist experienced in managing ROP is recommended.
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Affiliation(s)
- Yu-Hung Lai
- Department of Ophthalmology, Kaohsiung Medical University Hospital, Kaohsiung Medical University, Kaohsiung, Taiwan
- Department of Ophthalmology, School of Medicine, College of Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan
- Graduate Institute of Medicine, College of Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan
| | - Hsiu-Lin Chen
- Department of Pediatrics, Kaohsiung Medical University Hospital, Kaohsiung Medical University, Kaohsiung, Taiwan
- Department of Respiratory Therapy, College of Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan
| | - San-Nan Yang
- Department of Pediatrics, E-DA Hospital and School of Medicine, College of Medicine, I-Shou University, Kaohsiung, Taiwan
| | - Shun-Jen Chang
- Department of Kinesiology, Health, and Leisure Studies, College of Humanities and Social Sciences, National University of Kaohsiung, Kaohsiung, Taiwan
| | - Lea-Yea Chuang
- Graduate Institute of Medicine, College of Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan
- Department of Biochemistry, College of Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan
| | - Wen-Chuan Wu
- Department of Ophthalmology, Kaohsiung Medical University Hospital, Kaohsiung Medical University, Kaohsiung, Taiwan
- Department of Ophthalmology, School of Medicine, College of Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan
- Graduate Institute of Medicine, College of Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan
- * E-mail:
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Zhu X, Zhao R, Wang Y, Ouyang L, Yang J, Li Y, Pi L. Refractive state and optical compositions of preterm children with and without retinopathy of prematurity in the first 6 years of life. Medicine (Baltimore) 2017; 96:e8565. [PMID: 29137074 PMCID: PMC5690767 DOI: 10.1097/md.0000000000008565] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
Abstract
This study aimed to investigate the refractive state and optical compositions of preterm children with and without mild retinopathy of prematurity (ROP) and explore the influence of prematurity and mild ROP on the development of refractive state and optical compositions.Preterm children who received fundus screening were recruited, and divided into ROP group and non-ROP group. Term children matched in age were also recruited as controls. Several correspondence indicators were measured before and after ciliary muscle paralysis with 1% cyclopentanone.A total of 250 eyes from 126 patients were included for analysis. The incidence of myopia was the highest in ROP group. The incidence of hyperopia was the highest in control group. The incidence of astigmatism was the highest in ROP group. The corneal astigmatism and mean astigmatism in ROP group and non-ROP group were significantly higher than in control group. Corneal refraction in ROP was markedly higher than in non-ROP group and control group; corneal curvature in ROP group increased significantly as compared with non-ROP group and control group (P < .05). The axial eye length in ROP group and non-ROP group reduced significantly as compared with control group (P < .05). Gestational age had negative relationships with corneal astigmatism (P = .019) and astigmatism (P = .001) and positive relationship with axial eye length (P = .005). Birth weight had negative relationships with corneal astigmatism (P = .001), astigmatism (P < .001), corneal refraction (P = .001), and corneal curvature (P = .001) and positive relationships with axial eye length (P = .001) and spherical equivalent refraction (P = .039). The incidence of myopia increased and that of hyperopia reduced in children over age. In children aged 3 to 4 years, the anterior chamber depth, lens thickness, vitreous thickness, and axial eye length significantly increased as compared with those aged 5 years (P < .05); the vitreous thickness and axial eye length in children aged 5 years increased significantly as compared with those aged 6 years (P < .05).This study shows that preterm children with and without mild ROP are more likely to develop myopia and astigmatism, and low birth weight, prematurity, and ROP may simultaneously affect the development of optical compositions, leading to myopia and astigmatism.
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Fieß A, Schuster AK, Pfeiffer N, Nickels S. Association of birth weight with corneal power in early adolescence: Results from the National Health and Nutrition Examination Survey (NHANES) 1999-2008. PLoS One 2017; 12:e0186723. [PMID: 29073249 PMCID: PMC5658059 DOI: 10.1371/journal.pone.0186723] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/28/2017] [Accepted: 10/08/2017] [Indexed: 02/08/2023] Open
Abstract
Purpose To analyze the effect of birth weight on ocular morphology, refraction and visual function in early adolescents aged 12–15 years. Material and methods We conducted a secondary data analysis using the public use files from the National Health and Nutrition Examination Survey of the period from 1999 to 2008. Study participants aged 12 to 15 years were included with data on birth weight and ophthalmic parameters including presenting distance visual acuity, objective refraction and keratometry. Visual acuity, sphere, astigmatism in power vectors J0 and J45, corneal power and corneal astigmatism were evaluated for an association with birth weight. Linear and logistic regression with adjustment for age, sex, ethnicity, survey cycle and birth weight as independent variable were calculated. Results Linear regression analysis revealed an association between corneal power and birth weight (per 100g: beta = -0.04, p<0.001) in the univariate analysis, and in the model adjusted for age, sex, ethnicity and NHANES survey cycle (per 100g: beta = -0.04, p<0.001). A lower birth weight was associated with higher corneal power. We found no evidence for an association of visual acuity, sphere, spherical equivalent, J0-vector and J45-vector of astigmatism, corneal J0- or corneal J45-vector with birth weight. Conclusion Our data demonstrate that low BW is linked to alterations in keratometric power even in early adolescents aged 12–15 years whereas visual acuity and refractive error showed no association.
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Affiliation(s)
- Achim Fieß
- Department of Ophthalmology, University Medical Center Mainz, Mainz, Germany
- * E-mail:
| | | | - Norbert Pfeiffer
- Department of Ophthalmology, University Medical Center Mainz, Mainz, Germany
| | - Stefan Nickels
- Department of Ophthalmology, University Medical Center Mainz, Mainz, Germany
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Axial Length and Ocular Development of Premature Infants without ROP. J Ophthalmol 2017; 2017:6823965. [PMID: 29163989 PMCID: PMC5661099 DOI: 10.1155/2017/6823965] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/01/2017] [Revised: 07/24/2017] [Accepted: 08/17/2017] [Indexed: 02/07/2023] Open
Abstract
Purpose To investigate the ocular parameters of premature infants without ROP at gestational age (GA) more than 28 weeks and their relationship with growth parameters. Methods 76 preterm infants without ROP and 65 term infants were involved to undergo portable slit lamp, RetCam3, ultrasonic A-scan biometry, and cycloplegic streak examination at their 40 weeks' postconceptional ages (PCA). Ocular parameters of infants' right eye and growth parameters were used for analysis. Results All the infants were examined at 40 weeks' PCA. No significant difference was found between male and female in axial length of preterm infants (p = 0.993) and term infants (p = 0.591). Significant differences were found in axial length (AL), anterior chamber depth (ACD), lens thickness (LT), and vitreous depth (VD) between preterm and term infants. No significant correlation was found between AL and spherical equivalent in preterm infants' group. In preterm group, AL was significantly correlated with gestational age (GA), birth weight (BW), and head circumference (HC). Conclusions Preterm infants had shorter AL, shallow ACD, thicker LT, and thinner VD compared to term infants. Refractive error in preterm infants at GA between 28 to 37 weeks was not related to axial length. Among all the growth parameters of preterm infants, GA, BW, and HC had effect on axial length.
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Fieß A, Kölb-Keerl R, Knuf M, Kirchhof B, Blecha C, Oberacher-Velten I, Muether PS, Bauer J. Axial Length and Anterior Segment Alterations in Former Preterm Infants and Full-Term Neonates Analyzed With Scheimpflug Imaging. Cornea 2017; 36:821-827. [DOI: 10.1097/ico.0000000000001186] [Citation(s) in RCA: 27] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/16/2022]
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