Retinal structure and visual pathway function at school age in children born extremely preterm: A population-based study
Open accessAbstract
BACKGROUND: Children born extremely preterm (gestational age < 28 weeks) show reduced visual function even without any cerebral or ophthalmological neonatal diagnosis. In this study, we aimed to assess the retinal structure with optical coherence tomography (OCT) and visual function with pattern-reversal visual evoked potentials (PR-VEPs) in a geographically defined population-based cohort of school-aged children born extremely preterm. Moreover, we aimed to explore the association between measures of retinal structure and visual pathway function in this cohort. METHODS: All children born extremely preterm from 2006-2011 (n = 65) in Central Norway were invited to participate. Thirty-six children (55%) with a median age of 13 years (range = 10-16) were examined with OCT, OCT-angiography (OCT-A), and PR-VEPs. The foveal avascular zone (FAZ) and circularity, central macular vascular density, and flow were measured on OCT-A images. Central retinal thickness, circumpapillary retinal nerve fibre layer (RNFL) and inner plexiform ganglion cell layer (IPGCL) thickness were measured on OCT images. The N70-P100 peak-to-peak amplitude and N70 and P100 latencies were assessed from PR-VEPs. RESULTS: Participants displayed abnormal retinal structure and P100 latencies (≥ 2 SD) compared to reference populations. Moreover, there was a negative correlation between P100 latency in large checks and RNFL (r = -.54, p = .003) and IPGCL (r = -.41, p = .003) thickness. The FAZ was smaller (p = .003), macular vascular density (p = .006) and flow were higher (p = .004), and RNFL (p = .006) and IPGCL (p = .014) were thinner in participants with ROP (n = 7). CONCLUSION: Children born extremely preterm without preterm brain injury sequelae have signs of persistent immaturity of retinal vasculature and neuroretinal layers. Thinner neuroretinal layers are associated with delayed P100 latency, prompting further exploration of the visual pathway development in preterms.
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Low-quality vision has a more extensive inhibitory effect on neural activation within the parvocellular pathway.
“Visual occlusion resulted in significant reductions of both N75–P100 and P100–N135 amplitudes in both eyes, reflecting a more extensive inhibitory effect of low-quality vision on neural activation within the parvocellular pathway.[20,21]”
From Brain Rewires to Stabilize Walking During Visual Impairment · cites this paper as [20]
The Discussion (page unavailable) links lower-than-normal contrast sensitivity and delayed P100 latencies in children born extremely preterm to possible delayed parvocellular-pathway development. It does not establish that low-quality vision inhibits neural activation, or that visual occlusion produces the claimed amplitude reductions. (LLM, conf=0.78)
Experimental — accuracy not yet measuredLow-quality visual input inhibits the intensity of neural activation along the magnocellular pathway from the retina to the primary visual cortex.
“These reductions indicate that low-quality visual input inhibits the intensity of neural activation along the magnocellular pathway from the retina to the primary visual cortex.[20,21]”
From Brain Rewires to Stabilize Walking During Visual Impairment · cites this paper as [20]
The Discussion (page not provided) says the magnocellular pathway runs from the retina to the primary visual cortex and links thinner ganglion cell layers with delayed P100 responses to large checks, possibly indicating abnormal pathway development. It does not establish that low-quality visual input inhibits the intensity of neural activation; the reported finding concerns response latency, not intensity or causation. (LLM, conf=0.86)
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References 37 · Cited by 4
- Authors
- Ingvaldsen, S. H., Moljord, K., Grøtting, A., Omland, P. M., Dammann, O., Austeng, D., & Morken, T. S.
- Affiliations
- Norwegian University of Science and Technology (NO)
- St Olav's University Hospital (NO)
- Tufts University (US)
- Corresponding author
- Ingvaldsen, Sigrid Hegna
- ORCID
- Venue
- BMC Ophthalmology
- Published
- 2023-07-01
- Volume
- 23
- Issue
- 1
- Pages
- 296-296
- ISSN
- 1471-2415 (ISSN-L)
- PMC
- PMC10315021
- OpenAlex
- W4382794005
- Cited by
- 4
- References
- 37
- Citations by year
- 2026: 2 · 2025: 2
- FWCI
- 0.66
- Type
- journal article
- Language
- en
- Open access
- gold
- doi.org
- Locations
- BMC Ophthalmology (publishedVersion, cc-by)
- PubMed Central (publishedVersion, cc-by)
- PubMed (publishedVersion)
- DOAJ (DOAJ: Directory of Open Access Journals) (submittedVersion, cc-by-sa)
- NORA - Norwegian Open Research Archives (submittedVersion, cc-by)
- Funders
- NTNU Norwegian University of Science and Technology
- Topics
- Health Sciences › Medicine › Radiology, Nuclear Medicine and Imaging › Retinopathy of Prematurity Studies
- Health Sciences › Medicine › Pediatrics, Perinatology and Child Health › Infant Development and Preterm Care
- Life Sciences › Biochemistry, Genetics and Molecular Biology › Molecular Biology › Retinal Development and Disorders
- Keywords
- extremely preterm birth, retinal structure, visual pathway development, pattern visual evoked potential, P100 latency, retinal nerve fiber layer thickness, foveal avascular zone, macular vascular density, retinopathy of prematurity, elementary school students
- MeSH terms
- Adolescent, Child, Evoked Potentials, Visual, Humans, Infant, Infant, Newborn, Macula Lutea, Retina, Visual Pathways, Infant, Extremely Premature
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