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

BACKGROUND: To evaluate the association between severe retinopathy of prematurity (ROP), measures of brain morphology at term equivalent age (TEA), and neurodevelopmental outcome. METHODS: Eighteen 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 = 16) by GA, birth weight, sex, and brain injury T2- weighted images were obtained on a 3 T magnetic resonance imaging (MRI) at TEA. Brain volumes were computed using an automatic segmentation method. In addition, cortical folding metrics were extracted. Neurodevelopment was formally assessed at the ages of 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 the age of 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 the age of 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.