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Abnormal retinal optic nerve morphology in young adults after intrauterine growth restriction

Journal article
Authors David Ley
Karel Marsal
Jovanna Dahlgren
Ann Hellström
Published in Pediatr Res
Volume 56
Issue 1
Pages 139-43
Publication year 2004
Published at Institute of Clinical Neurosciences, Section of Ophtalmology
Institute for the Health of Women and Children, Dept of Paediatrics
Pages 139-43
Language en
Links file:///U:/EndNoteRefs/PDF_arkiv/Pe...
Keywords Adolescent, Adult, Fetal Growth Retardation/complications/*pathology, Humans, Infant, Newborn, Infant, Small for Gestational Age, Ophthalmoscopy, Optic Disk/*pathology, Optic Nerve/*abnormalities, Optic Nerve Diseases/etiology/*pathology, Research Support, Non-U.S. Gov't
Subject categories Medical and Health Sciences

Abstract

Intrauterine growth restriction (IUGR) is a recognized risk factor for neurologic deficits later in life. Abnormal fetal blood flow in the presence of fetal growth retardation helps to distinguish true fetal growth impairment from small but normally grown infants. The present study aimed to investigate the influence of IUGR with abnormal fetal blood flow on retinal optic nerve morphology at 18 y of age. A prospective study was performed in 19 subjects with IUGR [abnormal fetal aortic blood flow velocity; median birth weight deviation of -31% (-22 to -42%; median (range)] and in 23 subjects with a normal birth weight for gestational age [normal fetal aortic blood flow velocity; median birth weight deviation of -2% (-10 to 22%)]. All subjects were previously examined concerning minor neurologic dysfunction (MND) at 7 y of age. The ocular fundus was examined by ophthalmoscopy, and the optic nerve morphology was evaluated by digital image analysis. Decrease in neuroretinal rim area at 18 y of age was associated with increasing negative birth weight deviation (r = 0.71, p < 0.0001). The subjects with severe MND at 7 y had a reduced neuroretinal rim area [median (range), 1.57 mm(2) (1.37-1.78 mm(2))] compared with those with less severe MND [1.94 mm(2) (1.33-2.71 mm(2))] and with those with normal neurologic function [2.18 mm(2) (1.75-2.70 mm(2)); p < 0.05 and p < 0.0001, respectively]. A decrease in neuroretinal rim area reflects either a reduction in axonal volume or a decrease in the number of axons in the optic nerve. It is yet unclear whether this finding represents neuronal changes within other cerebral regions in subjects with IUGR.

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