Prevalence of foveal hypoplasia in a young adult cohort and its associations with visual acuity and birth parameters

Purpose This study describes the prevalence of foveal hypoplasia, the under-development of the fovea of the eye, in a young healthy adult cohort, using spectral domain-optical coherence tomography (SD-OCT) imaging, and correlations with visual acuity and birth parameters.Methods Participants were recruited from the Generation 2 (Gen2) of the Raine Study. At 20 years of age, Gen2 participants were invited to attend an eye examination including visual acuity with logMAR chart, contrast sensitivity and SD-OCT imaging. Birth weight and gestational age data were recorded at birth and data were extracted from medical records. Each SD-OCT scan was reviewed and graded for foveal hypoplasia severity with range 1 (mild) to 4 (severe). The Wilcoxon rank sum test and logistic regression were used to test for associations between foveal hypoplasia and visual function or birth parameter variables.Results After exclusions, 1231/1344 participants who attended the Gen2-20 year eye examination (2010–2012) were included in the analysis (n = 626 [51%] male). The prevalence of bilateral FH was 4.7% (n = 58), all of which were grade 1, mild foveal hypoplasia. Median visual acuity was similar for both the foveal hypoplasia and no foveal hypoplasia groups (−0.06 logMAR; p = .18) and median log10 contrast sensitivity was 1.28 and 1.20, respectively (p = .13). After adjusting for age, sex and refractive error, foveal hypoplasia was significantly associated with moderately premature birth (32 to <37 weeks; vs full-term odds ratio = 2.9, 95% confidence interval [CI]: 1.4, 6.0), very premature birth (≤32 weeks; vs full-term odds ratio = 9.5, 95% CI: 2.8, 32.5), and very low birth weight (≤1500 g; vs ≥2500 g, odds ratio = 9.5, 95% CI: 2.7, 33.1).Conclusions Mild foveal hypoplasia was relatively common in a healthy young adult population. Foveal hypoplasia was more common in participants born pre-term or with very low birth weight but was not associated with poorer visual acuity or contrast sensitivity.