Retinopathy of Prematurity Is Associated With Reduced Thalamic Volume and Impaired Neurodevelopment. A Cohort Study.

BACKGROUND: Retinopathy of prematurity (ROP) is a neurovascular disorder that may affect not only the retina but also the brain structures involved in visual processing. The relationship between ROP severity and the volumetric development of these regions remains unclear. METHODS: A total of 157 children aged 6-16 years, born preterm (24-36 weeks gestational age), were assessed. Perinatal data and comorbidities were collected. Brain MRI (3 T) data were analysed using FreeSurfer to obtain the volumes of the thalamus, fusiform gyrus, cuneus, lingual gyrus, lateral occipital gyrus, optic chiasm and calcarine sulcus. Cognitive performance was evaluated using the WISC-V. Multivariate regression analyses were adjusted for significant perinatal variables. RESULTS: The children with severe ROP had significantly smaller bilateral thalamic volumes (left Th: 6665 ± 672 mm3 vs. 7492 ± 820 mm3; p < 0.005) and a reduced right fusiform gyrus volume (p = 0.041) compared with those without ROP or only mildly affected. Severe ROP was also associated with lower full-scale IQ scores and reduced verbal comprehension, visuospatial reasoning, and working memory indices (p < 0.008). CONCLUSIONS: Severe ROP is associated with reduced thalamic and fusiform gyrus volumes as well as with lower cognitive performance, suggesting that ROP reflects a broader neurovascular disruption affecting central visual pathways.