Abstract
Background
To evaluate the association between severe retinopathy of prematurity (ROP), measures of brain morphology at term-equivalent age (TEA), and neurodevelopmental outcome.
Methods
Eighteen infants with severe ROP (median gestational age (GA) 25.3 (range 24.6–25.9 weeks) were included in this retrospective case–control study. Each infant was matched to two extremely preterm control infants (n=36) by GA, birth weight, sex, and brain injury. T2-weighted images were obtained on a 3 T magnetic resonance imaging (MRI) at TEA. Brain volumes were computed using an automatic segmentation method. In addition, cortical folding metrics were extracted. Neurodevelopment was formally assessed at the ages of 15 and 24 months.
Results
Infants with severe ROP had smaller cerebellar volumes (21.4±3.2 vs. 23.1±2.6 ml; P=0.04) and brainstem volumes (5.4±0.5 ml vs. 5.8±0.5 ml; P=0.01) compared with matched control infants. Furthermore, ROP patients showed a significantly lower development quotient (Griffiths Mental Development Scales) at the age of 15 months (93±15 vs. 102±10; P=0.01) and lower fine motor scores (10±3 vs. 12±2; P=0.02) on Bayley Scales (Third Edition) at the age of 24 months.
Conclusion
Severe ROP was associated with smaller volumes of the cerebellum and brainstem and with poorer early neurodevelopmental outcome. Follow-up through childhood is needed to evaluate the long-term consequences of our findings.
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Acknowledgements
We thank Karina Kersbergen, Ingrid van Haastert, and Tabitha Koops for their assistance in the data collection and Professor Margot van Eck van der Sluijs—van de Bor for supervising the first part of this study, which was part of a thesis.
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The work of Kristin Keunen is supported by a grant from the Wilhelmina Children’s Hospital Research Fund (Vrienden van het WKZ) to Martijn P. van den Heuvel. The work of Floris Groenendaal is supported by a grant from the Netherlands Organization for Health Research and Development (ZonMW; grant number 945-27-022).
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Drost, F., Keunen, K., Moeskops, P. et al. Severe retinopathy of prematurity is associated with reduced cerebellar and brainstem volumes at term and neurodevelopmental deficits at 2 years. Pediatr Res 83, 818–824 (2018). https://doi.org/10.1038/pr.2018.2
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DOI: https://doi.org/10.1038/pr.2018.2
