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Συστηματική ανασκόπηση: Η εικόνα οπτικής θηλής στα πρώην πρόωρα παιδιά (Master thesis)

Γεωργιάδου, Μιλένα

Aim: The purpose of this systematic review is to investigate reported values of the optic disc anatomical parameters, e.g. peripapillary retinal nerve fiber layer (pRNFL), disc area, rim area, cup area, rim volume, cup volume, c/d ratio) in children born preterm as compared to children born full-term. Methods: Α comprehensive literature search was perfomed in three databases (PubMed, Embase and Cochrane Library) from 1995 to November 2021. Data were collected on the peripapillary Retinal Nerve Fiber Layer (pRNFL) thickness as well as οn the parameters of the optic disc (disc area, rim area, cup area, rim volume, cup volume, c/d ratio) as measured by optical coherence tomography (Optical Coherence Tomography, OCT), Heidelberg Retinal Tomograthy (HRT) or fundus camera, in children aged < 18 years who were born preterm (< 37 weeks of gestational age) compared with children of the same age and gender who were born full-term ( 37 weeks). The exclusion criteria included the presence of co-morbidities such as Retinopathy of Prematurity (ROP), high myopia, brain damage. The initial search, the selection of primary studies and the data extraction were performed by two independent researchers. Qualitative synthesis of included studies, qualitative assessment of the validity of the findings, and the risk of bias assessment were also performed. Results: Our search yielded a total of 657 results. Five original observational studies met the inclusion criteria, of which one prospective cohort study and four cross-sectional studies. Three studies examined the pRNFL thickness (global, superior, temporal, inferior, nasal) and only one found significantly reduced RNFL (superior and temporal) in children born preterm compared to children born full-term. Two of the four studies that investigated optic disc parameters found significantly reduced rim area or rim volume in children born preterm compared to full-term children. Four of the five studies were judged to be at moderate risk of bias and only one at high risk of bias. The heterogeneity of the included studies in terms of prematurity threshold and the use of different imaging methods prevented a quantitative synthesis of the data. Conclusions: History of prematurity appears to be associated with reduced superior and temporal RNFL, reduced rim area and reduced rim volume. However, the limited number of studies, their heterogeneity, and the small number of participants in each study preclude drawing safe conclusions. Prospective cohort studies of sufficient sample size are needed to confirm the results.