Ophthalmology Science (Jan 2024)

Longitudinal Choroidal Development in Preterm Infants

  • Suzanne M. Michalak, MD,
  • Shwetha Mangalesh, MBBS,
  • Yineng Chen, MS,
  • Liangbo L. Shen, MD,
  • Vincent Tai, MS,
  • Katrina Winter, BS,
  • Neeru Sarin, MD,
  • Gui-shuang Ying, PhD,
  • Cynthia A. Toth, MD,
  • Lejla Vajzovic, MD,
  • Xi Chen, MD, PhD,
  • Charles M. Cotten, MD,
  • Mays Antioine El-Dairi, MD,
  • Sina Farsiu, PhD,
  • Sharon Freedman, MD,
  • Hesham Gabr, MD,
  • Sara Grace, MD,
  • Kathryn E. Gustafson, PhD,
  • Madja Hadziahmetovic, MD,
  • Joseph Izatt, PhD,
  • Ramiro Maldonado, MD,
  • Suzanne Michalak, MD,
  • Matthew O’Sullivan, MD,
  • Sally Ong, MD,
  • Miroslav Pajik, PhD,
  • Carolyn Pizoli, MD,
  • S. Grace Prakalapakorn, MD,
  • Joan Roberts, MD,
  • Alabi Rolake, MD,
  • Cynthia Toth, MD,
  • Nita Valikodath, MD,
  • Lejla Vajzovic, MD,
  • Christian Viehland, PhD,
  • David Wallace, MD,
  • Xiao Yi Zhou, MD,
  • Michelle McCall, BA, MCAPM,
  • Joanne Finkle, RN, JD,
  • Neeru Sarin, MBBS,
  • Alexandria Dandridge,
  • Ryan Imperio, BS,
  • Shwetha Mangalesh, MBBS,
  • William Raynor, BS,
  • Du Tran-Viet, BS,
  • Stephanie Chiu, PhD,
  • Heena Divecha, MS,
  • Vincent Tai, MS,
  • Katrina P. Winter, BS,
  • Kimberly Fisher, PhD, FMP-BC,
  • Lacey Andrews, BS,
  • Melissa Babilonia-Rosa, PhD,
  • Anne Baez Love, BS,
  • Lucy DeStefano-Pearce, MA,
  • Jessicka Hamilton, BA,
  • Grace Jefferson, MS,
  • Amanda Marion, BS,
  • Isabella Pallotto, MPH,
  • Marito Passero, BS,
  • Caitlin Stone, MA,
  • Michelle Sunico, BS,
  • Caelan Eckard, BSE,
  • Karthik Ganesan, BS,
  • Xiao Tang, MS,
  • Kira Wang, BA,
  • Brittany Wong, BS,
  • Mark Draelos, MD, PhD,
  • Francesco LaRocca, BS, MS, PhD,
  • Amit Narawane, BSE,
  • Qitong Gao, MS,
  • Isaac Bleicher, MD,
  • Pujan Patel, BS,
  • Jay Rathinavelu, BSE,
  • Kai Seely, MD, MHS,
  • Mason Seely, BS,
  • Maureen G. Maguire, PhD,
  • Gui-Shuang Ying, PhD,
  • Brendan McGeehan, MS,
  • Joshua Shimony, MD, PhD,
  • Dimitrios Alexopoulos, MS,
  • Sydney Kaplan, BS,
  • Jeanette Kenley, BS,
  • Kayla Hannon, BS,
  • Brian P. Smith, MD, MPH, MHS,
  • Michael O’Shea, MD, MPH,
  • Subashri Kurgatt, PhD,
  • Daniel X. Hammer, PhD,
  • William Good, MD.

Journal volume & issue
Vol. 4, no. 1
p. 100359

Abstract

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Purpose: To characterize changes in subfoveal choroidal thickness in preterm infants from 30 to 60 weeks' postmenstrual age (PMA). Design: The prospective, observational Study of Eye Imaging in Preterm infantS (BabySTEPS) enrolled infants eligible for retinopathy of prematurity screening per the American Association of Pediatrics guidelines. Subjects: Infants imaged with an investigational, handheld OCT at ≥ 4 distinct imaging sessions between 30 to 60 weeks' PMA as part of BabySTEPS. Methods: Average choroidal thickness across the central subfoveal 1 mm in each eye at each time point was measured using custom segmentation software, and errors were manually corrected by a trained grader. We prospectively collected birth history data. A segmented mixed model was used to analyze the change in choroidal thickness as a function of PMA, birth weight, and gestational age (GA). Main Outcome Measures: Characterization of normative subfoveal choroidal thickness values and choroidal growth rate between 30 to 60 weeks' PMA. Results: We included 592 imaging sessions of 79 preterm infants (152 eyes). Mean (± standard deviation) GA was 27.5 ± 2.5 weeks. Mean choroidal thickness was 141.4 ± 34.5 μm at 30 weeks, 272.2 ± 83.9 μm at 38 weeks, and 306.2 ± 77.4 μm between 56 and 60 weeks. Between 30 and 60 weeks' PMA, choroidal growth followed a biphasic model, with a linear growth rate of 14.8 μm per week (95% confidence interval [CI], 13.6–16.0) from 30 until 38.4 weeks, then cessation of growth, with a growth rate of 0.3 μm per week (95% CI, −1.1 to 1.6) from 38.4 to 60 weeks. Infants with extremely low birth weight (ELBW; < 1000 g) and extremely preterm (GA < 28 weeks) infants had significantly slower initial growth rates compared with very low and low birth weight and very preterm and preterm infants (ELBW 13.0 vs. 21.0 μm per week; P < 0.0001 and extremely preterm 13.2 vs. 18.0 μm per week; P = 0.003). Conclusions: Preterm infant choroidal thickness experiences rapid linear growth from 30 to 38 weeks' PMA, at which time growth nearly stops. These foundational measurements and identification of the impact of extremes of low birth weight and prematurity on choroidal development will be essential as researchers begin to understand the role of choroidal development in ocular and retinal health in human infants. Financial Disclosure(s): Proprietary or commercial disclosure may be found in the Footnotes and Disclosures at the end of this article.

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