# Ocular fundus and optical coherence tomography (OCT) findings in children prenatally exposed to opioid maintenance therapy (OMT)

## TL;DR

This study finds that children exposed to opioids in the womb have thinner retinal layers, suggesting potential fetal neurodevelopmental effects.

## Contribution

First study to report OCT findings in children prenatally exposed to opioid maintenance therapy.

## Key findings

- OMT-exposed children showed significant thinning of the peripapillary retinal nerve fiber layer.
- Reduced retinal thickness and volumes were observed in several macular regions.
- No correlation was found between OCT data and visual acuity in the studied children.

## Abstract

Optical coherence tomography (OCT) has been of great importance in the diagnostics and follow-up of many retinal diseases the last 25 years. More recently, this technology has also proved useful in the evaluation and follow-up of various neurological and psychiatric disorders. Also, certain prenatal impacts, such as prematurity and foetal alcohol spectrum disorder have shown abnormal findings on OCT. The aim of this study was to examine children that have been prenatally exposed to opioid maintenance therapy (OMT) with OCT.

As a part of a comprehensive study on visual and visual-motor function, 63 children aged 5–13 years exposed prenatally to OMT and 77 age-matched controls were examined with OCT, collecting data from the peripapillary retinal nerve fibre layer (RNLF) and the macular region. The participants were recruited at two different centres with different OCT-instruments.

A highly significant thinning of the peripapillary RNFL was found in the OMT-exposed children compared to the controls at both study centres. The macular data did also show a reduced retinal thickness and volumes in several macular regions in the OMT-exposed children, but to a variable degree at the two participating study centres. The reasons for this variability remain uncertain. There was no correlation between the OCT data and visual acuity.

This is the first study reporting OCT-data from children prenatally exposed to OMT. The significant thinning of the peripapillary RNFL in the OMT-exposed children most probably reflects a negative impact of the opioid substances on the foetal neurodevelopment. Further OCT-studies on OMT-exposed children should be carried out.

The online version contains supplementary material available at 10.1186/s12886-025-04342-y.