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Purpose: To investigate central retinal morphology and optic retinal nerve fibre layer (RNFL) in prematurely born young adults and compare to term born controls. Materials and Methods: The participants were 59 prematurely born individuals, with a birthweight <= 1.500 g, and 44 term born controls, all 25-29 years of age. Visual acuity (VA) and contrast sensitivity (CS) were assessed. The retinal macular thickness, ganglion cell-inner plexiform layer (GC-IPL) thickness and RNFL thickness were assessed with Cirrus optical coherence tomography (OCT). Results: Central macular thickness was increased (mean 26.7 mu m) in prematurely born individuals compared to controls. The macular GC-IPL was thinner (mean 3.84 mu m), also when excluding those with previous retinopathy of prematurity (ROP) and those with neurological complications. Gestational age at birth and previous treatment of ROP were risk factors for a thicker macula, however, not for reduced GC-IPL. The average peripapillary RNFL was thinner (mean 4.61 mu m) in the prematurely born individuals, also when excluding those with previous ROP and/or neurological complications. Within the prematurely born group, treated ROP was correlated with increased average RNFL. Further, both better VA and CS were associated with thinner optic nerve RNFL and thicker average GC-IPL. Conclusion: Macular and optic nerve morphology were influenced by premature birth as assessed with OCT in adult individuals. Gestational age at birth and treatment for ROP seemed to affect central macular thickness, and treated ROP affected the peripapillary RNFL. Thus, retinal sequelae remained in adulthood.

Importance: Knowledge of the incidence and progression of diabetic retinopathy (DR) after gastric bypass surgery (GBP) in patients with obesity and diabetes could guide the management of these patients. Objective: To investigate the incidence of diabetic ocular complications in patients with type 2 diabetes after GBP compared with the incidence of diabetic ocular complications in a matched cohort of patients with obesity and diabetes who have not undergone GBP. Design, Setting, and Participants: Data from 2 nationwide registers in Sweden, the Scandinavian Obesity Surgery Registry and the National Diabetes Register, were used for this cohort study. A total of 5321 patients with diabetes from the Scandinavian Obesity Surgery Registry who had undergone GBP from January 1, 2007, to December 31, 2013, were matched with 5321 patients with diabetes from the National Diabetes Register who had not undergone GBP, based on sex, age, body mass index (BMI), and calendar time (2007-2013). Follow-up data were obtained until December 31, 2015. Statistical analysis was performed from October 5, 2018, to September 30, 2019. Exposure: Gastric bypass surgery. Main Outcomes and Measures: Incidence of new DR and other diabetic ocular complications. Results: The study population consisted of 5321 patients who had undergone GBP (3223 women [60.6%]; mean [SD] age, 49.0 [9.5] years) and 5321 matched controls (3395 women [63.8%]; mean [SD] age, 47.1 [11.5] years). Mean (SD) follow-up was 4.5 (1.6) years. The mean (SD) BMI and hemoglobin A1c concentration at baseline were 42.0 (5.7) and 7.6% (1.5%), respectively, in the GBP group and 40.9 (7.3) and 7.5% (1.5%), respectively, in the control group. The mean (SD) duration of diabetes was 6.8 (6.3) years in the GBP group and 6.4 (6.4) years in the control group. The risk for new DR was reduced in the patients who underwent GBP (hazard ratio, 0.62 [95% CI, 0.49-0.78]; P < .001). The dominant risk factors for development of DR at baseline were di

Purpose: Diverging results have been reported with regards to the occurrence and progression of diabetic retinopathy following gastric bypass surgery (GBP) in patients with diabetes. We aimed to investigate the incidence of diabetic ocular complications in a nationwide study in Sweden in obese patients with type 2 diabetes mellitus (T2DM) following GBP and compared to a matched cohort of patients with T2DM not subjected to GBP surgery. Setting: Nationwide registry study in Sweden. Methods: We used data from two nationwide registers in Sweden: the Scandinavian Obesity Surgery Registry (SOReg) and the National Diabetes Registry (NDR). Patients with T2DM who had undergone GBP 2007-2013 reported to the SOReg were matched (1:1) with patients with T2DM from the NDR who had not had GBP surgery for obesity, based on sex, age, body mass index (BMI) and calender time (year). Follow-up data were obtained until December 31, 2015. The main outcome was occurrence of new diabetic retinopathy and was assessed with Cox proportional-hazards regression model. The importance of potential risk factors was assessed using a machine learning approach. Results: The study population consisted of 5321 patients who had undergone GBP and 5321 matched controls in NDR, and was followed up for a mean of 4.5 years. Mean age was 49.0 (SD 9.5) in the GBP and 47.1 (11.5) years in the control patients, respectively. BMI and HbA1c at baseline were 42.0 (5.7) and 60.0 (16.8) in the GBP group and 40.9 (7.3) kg/m2 and 58.5 (16.9) mmol/mol in the control group. Duration of diabetes was approximately 6 years in both groups. The risk for new diabetic retinopathy was reduced in the GBP patients (hazard ratio [HR] 0·62, 95% CI 0·49–0·78; p<0.001). The most important risk factors for development of diabetic retinopathy were diabetes duration, HbA1c, glomerular filtration rate (GFR), use of insulin and BMI. There was no evidence of increased risk for development of sight-threatening or treatment-requiring diab

PURPOSE: To examine the optic nerve head with Heidelberg tomography (HRT) in prematurely born school-age children and compare them to children born at term. METHODS: Sixty-three 5-16-year-old children born with a gestational age (GA) of ≤32 weeks were included in the study and compared to 54 children of the same age, born at term. In the preterm group, 29 children had had retinopathy of prematurity (ROP) and nine children had neurological complications. The optic nerve head was assessed with HRT. Three measurements were performed, and the different topographic parameters were noted. RESULTS: Rim area of the optic nerve was significantly smaller in prematurely born children than in children born at term. The mean difference was 0.146 mm2 (p = 0.02). No difference between the groups was found regarding disc area or cup area. In the preterm group, both disc and rim areas were reduced with increasing GA. No correlations with birthweight, ROP or neurological complications were found. CONCLUSION: Reduced rim area of the optic nerve head was found in preterm children of school age. Previous ROP or neurological complication did not influence the result, suggesting the preterm birth per se was the reason for the reduction. Establishing whether this finding was caused by disturbed maturation of the optic nerve or by injury of the axons, or a combination of the two, will require further research.

IMPORTANCE The function of rods and cones in children born extremely preterm has not yet been fully investigated. OBJECTIVE To compare retinal function via full-field electroretinographic (ffERG) recordings in 6.5-year-old children born extremely preterm with children born at term. DESIGN, SETTING, AND PARTICIPANTS A subcohort study was conducted from July 1, 2010, to January 15, 2014, of the national Extremely Preterm Infants in Sweden Study, including preterm children (< 27 weeks' gestational age) and children born at term, at 6.5 years of age and living in the Uppsala health care region in Sweden. Full-field electroretinography was performed binocularly, using DTL electrodes and electroretinographic (ERG) protocols with flash strengths of 0.009, 0.17, 3.0, and 12.0 candelas (cd)/s/m(2), together with 30-Hz flicker and 3.0 cd/s/m(2) single-cone flash. MAIN OUTCOMES AND MEASURES The ffERG recordings were analyzed, and their associations with gestational age and retinopathy of prematurity were examined. RESULTS Adequate ffERG recordings were obtained from 52 preterm children (19 girls and 33 boys; mean [SD] age at examination, 6.6 [0.1] years) and 45 children born at term (22 girls and 23 boys; mean [SD] age at examination, 6.6 [0.1] years). Lower amplitudes of the combined rod and cone responses (the a-wave of the dark-adapted ERG protocol of 3.0 cd/s/m(2): mean difference, -48.9 mu V [95% CI, -80.0 to -17.9 mu V]; P =. 003; the a-wave of the dark-adapted ERG protocol of 12.0 cd/s/m(2): mean difference, -55.7 mu V [95% CI, -92.5 to -18.8 mu V]; P = .004), as well as of the isolated cone response (30-Hz flicker ERG: mean difference, -12.1 mu V [95% CI, -22.5 to -1.6 mu V]; P = .03), were found in the preterm group in comparison with the group born at term. The implicit time of the combined rod and cone responses (the a-wave of the dark-adapted ERG protocol of 12.0 cd/s/m(2)) was longer (mean difference, 1.2 milliseconds [95% CI, 0.3-2.0 milliseconds]; P = .01) in

To create normative data in children from binocular multifocal ERG (mfERG) recordings and compare results with the macular thickness.

PURPOSE: Prematurely born children have affected visual functions at school age. Optical coherent tomography (OCT) has shown morphological changes in the retina, suggesting a disturbance in normal retinal development in these children. The aim of this study was to examine retinal function with fullfield electroretinogram (ffERG) in school-aged children born prematurely and compare with children born at term. A second aim was to correlate retinal function with visual acuity (VA), gestational age (GA), birth weight, and retinopathy of prematurity (ROP). METHODS: The study group consisted of 35 former preterm children born before GA of 32 weeks. A group of 42 children born at term acted as controls. All children were between 5- and 18-years old. FfERG was performed in both eyes. Best-corrected VA and refraction in cycloplegia was determined. RESULTS: The a-wave of the combined rod/cone responses was significantly reduced in the prematurely-born children compared with children born at term. There was a correlation between reduced a-wave amplitude in the combined rod/cone response and ROP and GA at birth. CONCLUSION: Function of photoreceptors was affected in prematurely born children, possibly also in children without previous ROP. Whether immaturity per se affects the retinal function remains to be elucidated.