Severe retinopathy of prematurity is associated with reduced cerebellar and brainstem volumes at term and neurodevelopmental deficits at 2 years

OBJECTIVE: To evaluate the association between severe retinopathy of prematurity (ROP), measures of brain morphology at term equivalent age (TEA) and neurodevelopmental outcome.

PATIENTS AND METHODS: 18 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 3T MRI at TEA. Brain volumes were computed using an automatic segmentation method. Additionally, cortical folding metrics were extracted. Neurodevelopment was formally assessed at age 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 age 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 age 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.Pediatric Research accepted article preview online, 10 January 2018. doi:10.1038/pr.2018.2.