Morphological features of retinal development in premature Chinese infants observed by computer-assisted indirect ophthalmoscope imaging

Objective To investigate retinal maturation in premature infants (gestation age <37 weeks). using computer-assisted indirect ophthalmoscope imaging. Methods Premature infants at postmenstrual age 33–46 weeks, who underwent fundus examinations using computer-aided indirect ophthalmoscopy, were stratified into seven postmenstrual-age groups. Images of macular morphology, peripheral retinal vascularization and fundus pigmentation were compared. Results The study included 268 infants in the following postmenstrual-age groups: 33–34 weeks (n = 19), 35–36 weeks (n = 37), 37–38 weeks (n = 49), 39–40 weeks (n = 55), 41–42 weeks (n = 49), 43–44 weeks (n = 34), and 45–46 weeks (n = 25). The macula matured with increasing postmenstrual age. A mature macula was observed in 92% of infants at 45–46 weeks. Complete vascularization was achieved at 41–42 weeks in the nasal retina and at 43–44 weeks in the temporal retina. The number of retinas with normal pigmentation increased with postmenstrual age (rising to 84% of infants at postmenstrual age 45–46 weeks). Conclusions Following premature birth, macular morphology, retinal vascularization and retinal pigmentation continue to develop. This study provides reference images of normal retinal development in premature infants.