Purpose: To characterize changes in the macular structure and vascularity seen in premature-birth adults.
Methods: Retrospective review of adult patients seen in the clinic from July 2018 to November 2020 with history of premature birth not requiring treatment for retinopathy of prematurity, as well as healthy controls. Swept-source ocular coherence tomography-angiography scans were analyzed for various parameters related to the macular structure and vascularity. Statistical analysis was performed using univariate linear regression.
Results: Thirty-four eyes were included (17 eyes from 10 premature-birth adults, 17 eyes from 11 control patients). Prematurity was associated with vascular changes on ocular coherence tomography-angiography: decreased foveal avascular zone area ( P = 0.001), decreased foveal avascular zone circularity index ( P < 0.001), decreased superficial capillary plexus vessel density ( P = 0.02), and decreased deep capillary plexus vessel density ( P < 0.001). Prematurity was also associated with structural changes: shallower foveal pit depth ( P < 0.001), decreased cube average thickness ( P = 0.005), and increased central subfield thickness-to-cube average thickness ratio ( P = 0.002).
Conclusion: This is the largest published series of ocular coherence tomography-angiography data for premature-birth adults. Even without a history of retinopathy of prematurity treatment, premature birth is associated with multiple changes to the macular structure and vascularity that persist into adulthood. These include a smaller, more irregularly shaped foveal avascular zone, decreased juxtafoveal vascular density, and a shallower foveal pit.