Analysis Of Refractive Status And Thickness Of Retinal Nerve Fiber Layer In Children With Or Without Retinopathy Of Prematurity At Eight Years Old

Objective:To compare the refractive status and retinal nerve fiber layer thickness(RNFLT)in preterm children with or without retinopathy of permaturity(ROP)at eight years old,and to analyze the effects of preterm birth and ROP on refractive status and RNFLT.Methods:From January 2009 to February 2011,premature babies(average gestational week:33.57±4.10W,average birth weight:2098.67±778.88g)who underwent fundus screening in the department of Ophthalmology,Children's Hospital of Chongqing Medical University were divided into ROP group and preterm group,and full-term babies of the same age were used as controls.The RNFLT and axial length(AL)were measured at the age of eight.Retinoscopy was performed after ciliary muscle paralysis with 1%cyclopentanone at the same time.The changes in the incidence of myopia,hyperopia,and astigmatism and the differences in RNFLT among the three groups were compared.Results:A total of 112 people(222 eyes)were enrolled,including 24in ROP group(47 eyes),55 in preterm group(110 eyes),and 33 in full-term group(65 eyes).The incidence of myopia(X~2=8.062,X~2=3.671,P<0.05)and astigmatis(X~2=7.758,X~2=3.710,P<0.05)in ROP group and preterm group were higher than those in full-term group.There was no significant difference in the incidence of hyperopia(X~2=4.910,P>0.05).The AL of the ROP group and preterm group was shorter than that of full-term group(F=5.243,F=4.701,P<0.001).The average RNFLT of preterm group was thinner than that of full-term group(F=2.593,P=0.030).The temporal quadrant RNFLT of preterm group was thinner than that of full-term group(F=5.246,P<0.001)and ROP group(F=5.528,P<0.001).There were no significant differences in RNFLT in other quadrants(P>0.05).There were no significant differences in RNFLT in the superior,inferior and nasal quadrants around the optic disc among the three groups(F=0.614,F=1.456,F=1.607,all P>0.05).The average RNFLT was different among the three groups(F=3.44,P=0.034).The average RNFLT of the preterm group was thinner than that of the full-term group(F=2.593,P=0.030).There was no difference between the ROP group and preterm group(F=0.492,P>0.05),and there was no difference between the ROP group and full-term group(F=1.671,P>0.05).The RNFLT in the temporal quadrant around the optic disc was different among the three groups(F=21.794,P<0.001).Further comparison showed that the temporal RNFLT of the preterm group was thinner than that of the ROP group and the full-term group(F=5.528,F=5.246,all P<0.001),there was no difference in temporal RNFLT between ROP group and full-term group(F=0.745,P<0.960).Conclusions:(1)The preterm children and children with ROP have shorter AL at eight years old,and are more prone to have myopia and astigmatism.(2)The ROP and premature affect their refractive status,and premature plays a major role.(3)The effect of premature delivery and ROP on RNFLT is different.Premature delivery is related to thinning of RNFLT and ROP is related to thickening of RNFLT in the temporal quadrant.