Structural consequences of arrested foveal development in preterms with persisting signs of immaturity

PURPOSE: To evaluate the impact of structural changes in a limited sample of adult preterms with foveal immaturity from optical coherence tomography (OCT) B-scan images and to estimate layer displacement and changes in areal and volume magnification within the inner fovea. SUBJECTS AND METHODS: Layer thickness was measured in conventional and directional OCT scans from eight preterms with different degrees of foveal immaturity (24–33 weeks of gestation, 22–33 years of age) and five controls (20–33 years of age). We obtained reflectivity profiles of the outer plexiform layer (OPL) and manual segmentation data of the inner nuclear layer (INL) and the combined ganglion cell layer (GCL) and inner plexiform layer (IPL) at specified eccentricities from 300 to 900 µm. Displacement of cumulative thickness curves of preterms compared with that of the controls was used to estimate retardation of layer displacement. Changes in areal magnification and layer thickness were used to construct a structural model of redistribution within the fovea of preterms. RESULTS: Retardation of centrifugal layer displacement of OPL and all inner retinal layers (IRL) was marked in both preterm groups with foveal immaturity, whereas retardation was marginal in the preterm group without clinical signs of immaturity. Retarded displacement within the IRL and OPL had a major impact on available space within the central fovea. CONCLUSIONS: A marked retardation of displacement was demonstrated for all IRL within the immature fovea of preterms with decreased areal and volume magnification and reduced space available for synaptic communication coupled to the degree of immaturity.