Central Corneal Thickness in Prematurity Linked to Ethnicity, Gestational Age, Birthweight

Optometrist woman checks girl eyesight. Diagnosis of eye anterior segment and tomography of boy eyes. Vision correction
CCT often decreased to normal thickness by 44 weeks postmenstrual age, the report shows.

Among premature infants, changes to central corneal thickness (CCT) were observed to vary on the basis of ethnicity, gestational age. These findings, from an assessment of eye health among premature infants, were published in the Canadian Journal of Ophthalmology.

Premature infants (N=87) born between 2018 and 2019 at the University of Florida were screened for retinopathy of prematurity (ROP).

Infants were 55.2% girls, born at a mean gestational age of 28.2 (standard deviation [SD], 2.7) weeks, birthweight was 1076.3 (SD, 332.7) grams, 41.1% were White, 40.2% were Black, 5.7% were Hispanic, and 3.4% were Asian.

Most infants did not meet the standard for ROP treatment (80.5%), 10.3% were given intravitreal bevacizumab monotherapy and 9.2% received intravitreal bevacizumab and pan-retinal photocoagulation.

CCT decreased by an average of 12.3 μm/week (P <.001). Babies born before 27 weeks of age had significantly higher CCT at baseline (mean, 717.0 vs 682.4 μm; P =.036) but decreased at a faster rate (mean, −13.3 vs −10.1 μm/week; P =.029).

CCT was also associated with ethnicity, with White infants having the thickest and Hispanic infants having the thinnest corneas (P <.01). The change in CCT was −16.3 μm/week for Asian infants, −13.59 μm/week for White infants, −11.5 μm/week for Black infants, and −5.2 μm/week for Hispanic infants.

At initial assessment, 37 had corneal haze and 9 did not. Infants with corneal haze had thicker corneas (738 vs 682.3 μm), were heavier at birth (mean, 1044.6 vs 861.1 g), more were White (51.4% vs 0.0%), fewer were Black (29.7% vs 77.8%). Infants with corneal haze were also less likely to need oxygen supplementation (43.2% vs 66.7%), and more likely to not receive ROP therapy (81.1% vs 55.6%).

This study was limited by its ethnic imbalance of the study population.

These data indicated that CCT decreased to normal thickness by 44 weeks postmenstrual age. The rate of CCT decline was associated with ethnicity, birthweight, and gestational age. Additional, larger studies are needed to confirm these observations and to identify additional cofactors.


Islam Y, Xue W, Agarwal-Sinha S. Correlation of central corneal thickness and associated factors in premature infants with and without retinopathy of prematurity. Can J Ophthalmol. 2021;56(3):171-178. doi:10.1016/j.jcjo.2020.09.006