Optical coherence tomography shows decreased thickness of retinal nerve fibre layer among foetal alcohol exposed young adults in a case–control study
Bibliographic record
Abstract
Foetal alcohol spectrum disorder is an umbrella term that describes all the foetal alcohol effects. We lack a reliable biomarker to detect foetal alcohol exposure and a uniform way to diagnose foetal alcohol spectrum disorder (Cook 2003; Coles et al. 2016). The eye is a sensitive indicator of prenatal adverse events, and the eyes and visual system are often damaged by maternal alcohol misuse during the pregnancy (Stromland & Pinazo-Duran 2002). Among the most frequent abnormalities are optic nerve hypoplasia and increased tortuosity of retinal vessels (Abdelrahman & Conn 2009). The aim of the present study was to evaluate peripapillary retinal nerve fibre layer (RNFL) thickness using optical coherence tomography (OCT) among foetal alcohol exposed young adults. We invited twelve previously studied (Riikonen et al. 2005) young adults suffering from foetal alcohol syndrome (FAS) and foetal alcohol effects (FAE) to take part in the ophthalmological examination including OCT. Ten out of the twelve subjects accepted the invitation, and they were examined in the Ophthalmology Clinic of Kuopio University Hospital (Finland) during 2012–2013. All subjects were previously confirmed cases of foetal alcohol exposure. The diagnostic criteria of FAS and more detailed characteristics of the subjects have been described previously (Riikonen et al. 2005). The control subjects were recruited from the circle of acquaintances of the personnel and from medical students of University of Eastern Finland. They were healthy non-smoking and not exposed to alcohol during the pregnancy. The study included one on-site visit in the Ophthalmology Clinic of Kuopio University Hospital. A standard ophthalmological examination including indirect ophthalmoscopy and measurement of the vision was performed to exclude eye diseases. Optical coherence tomography (OCT) was performed using OTI OCT-SLO (Ophthalmic Technologies Inc., Toronto, Canada). The study protocol was approved by the Ethics Committee of Kuopio University Hospital. All study participants provided an informed written consent. Data management and the statistical analyses were performed using SPSS 24 (SPSS Inc., Chicago, IL). The mean age of the FAS/FAE group was 20.7 years (SD 3.3) and that of the control group 20.5 years (SD 4.3). Six out of ten in both study groups were females. One person in the FAS/FAE group had missing value of the right eye OCT. We found that the mean peripapillary RNFL thickness was smaller in the FAS/FAE group compared to the controls and in all peripapillary segments except for the right eye nasal quadrant (Table 1). Optical coherence tomography (OCT) with RNFL thickness measurement is a potentially useful tool to evaluate the effects of preceding alcohol exposure during the pregnancy. To our knowledge, only one study has previously investigated optic nerve thickness with OCT in FAS and our results are in line with that study (Menezes et al. 2016). We suggest that this finding should be studied in a larger sample and with more advanced equipments to evaluate whether RNFL thickness could be used as a detection tool for foetal alcohol exposure.
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How this classification was reachedexpand
Full frame distilled prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. Learned from the 10,348 direct Codex labels and 10,348 direct Gemma labels. Candidate is the union of thresholded teacher heads; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels or direct frontier model labels.
Codex and Gemma teacher scores by category
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.001 | 0.002 |
| Meta-epidemiology (narrow) | 0.001 | 0.001 |
| Meta-epidemiology (broad) | 0.003 | 0.001 |
| Bibliometrics | 0.001 | 0.001 |
| Science and technology studies | 0.000 | 0.001 |
| Scholarly communication | 0.000 | 0.000 |
| Open science | 0.001 | 0.000 |
| Research integrity | 0.002 | 0.004 |
| Insufficient payload (model declined to judge) | 0.001 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; both teacher heads agree on what is shown here.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".