Sex-Specific Differences in the Relationship Between Prematurity and Ocular Geometry

PURPOSE. To explore differences in the relationship between gestational age (GA) and birth weight (BW) percentile and ocular geometry between males and females. METHODS. The Gutenberg Prematurity Eye Study involved a prospective ophthalmic examination of adults, aged 18 to 52 years, who were born preterm or at term, in Germany. The associations between GA and BW percentile on the main outcome measures were evaluated by uni- and multivariable linear regression analyses. The main outcome measures were central corneal thickness, corneal radius, anterior chamber depth, lens thickness, posterior segment length, and central foveal thickness. Potential sex-specific differences and an effect modification by sex were analyzed. RESULTS. This study involved 438 participants (245 females, 193 males) with an average age of 28.6 +/- 8.7 years. In female participants, central foveal thickness was negatively associated with a higher GA (B = - 2.99; P < 0.001). Similarly, male participants also demonstrated a negative association between central foveal thickness and GA (B = - 4.27; P < 0.001). The multivariable model with effect modification revealed that the central foveal thickness was thicker with lower GA. There was an association between the effect modification of GA with sex and central foveal thickness, demonstrating a more pronounced effect of GA on central foveal thickness in male participants (B = 1.29; P = 0.04). CONCLUSIONS. This study identified a sex-specific correlation between lower GA and thicker central foveal thickness, suggesting differences in the developmental trajectory of this biometric parameter concerning GA. A thicker central foveal thickness might affect the visual acuity of individuals born preterm in adulthood, with a more pronounced impact in males and a potential predisposition to age-related diseases later in life. Sex did not influence the association of GA or BW percentile to other ocular geometric parameters.