FOVEAL AVASCULAR ZONE IN ADULTS BORN PRETERM WITH AND WITHOUT RETINOPATHY OF PREMATURITY Results From The Gutenberg Prematurity Eye Study

Purpose: To examine potential changes in the foveal avascular zone (FAZ) during adulthood due to prematurity and retinopathy of prematurity (ROP), as assessed by measurements of the FAZ area and circularity. Methods: The Gutenberg Prematurity Eye Study is a retrospective German cohort study with a prospective ophthalmologic examination of adults aged 18 years to 52 years, born either preterm or full-term, using spectral-domain optical coherence tomography angiography. Participants were categorized into groups based on gestational age and postnatal ROP status. The study conducted multivariable linear regression analyses to explore associations with the FAZ. Results: The study cohort comprised 380 right eyes from individuals born both preterm and full-term, with an average age of 28.4 years +/- 8.6 years, including 214 women. The FAZ area decreased as gestational age decreased: FAZ was 0.28 mm(2) +/- 0.12 mm(2) in the control group, 0.21 +/- 0.10 mm(2) at GA 33 weeks to 36 weeks, 0.18 mm(2) +/- 0.10 mm(2) at GA 29 weeks to 32 weeks, 0.11 mm2 +/- 0.10 mm(2) at GA <= 28 weeks, 0.11 mm(2) +/- 0.10 mm(2) in ROP without treatment, and 0.11 mm2 +/- 0.10 mm2 in those requiring ROP treatment. In the multivariable analyses, smaller FAZ was independently associated with gestational age (P < 0.05), increased foveal retinal thickness (P < 0.05), and foveal hypoplasia (P < 0.05). Moreover, no association was seen between visual acuity and FAZ. Conclusion: The main perinatal factor associated with a smaller FAZ in this German cohort is preterm birth, while ROP, ROP treatment, or other perinatal factors do not affect FAZ observed in adulthood. A smaller FAZ shape in preterm individuals might be an indicator of foveal hypoplasia.