Abstract
BACKGROUND: Ocular biometric measurements are influenced by age, race, and environmental factors; however, data on intraocular pressure (IOP) and central corneal thickness (CCT) in African preterm neonates remain limited. This study describes IOP and CCT measurements and examines their associations with selected perinatal characteristics in preterm infants in Ibadan, Nigeria. METHODS: This cross-sectional, hospital-based study included clinically stable preterm infants (26 to < 37 weeks’ gestation) who were examined within two weeks of birth at University College Hospital, Ibadan, between March 2021 and February 2022. The primary outcome measures were IOP (mmHg) and CCT (µm), assessed using the iCare PRO rebound tonometer and Appascan Max ultrasonic pachymeter, respectively. Gestational age, birth weight, sex, mode of delivery, and antepartum maternal steroid exposure were evaluated as predictors using linear mixed-effects regression models that accounted for inter-eye correlation. RESULTS: A total of 162 eyes of 81 preterm infants (mean gestational age: 32.4 ± 2.8 weeks; 54% male) were analysed. The mean ± SD IOP was 16.5 ± 3.8 mmHg, and the mean CCT was 648 ± 75 μm. Intraocular pressure increased by 0.6 mmHg for every 50 μm increase in CCT. Higher birth weight, lower gestational age, female sex, and antepartum maternal steroid exposure were associated with higher IOP. Higher gestational age, female sex, and antepartum maternal steroid exposure were associated with thinner CCT, while spontaneous vaginal delivery was associated with thicker CCT. The proportion of variance explained by perinatal factors was modest. CONCLUSION: In this cohort of clinically stable preterm infants, IOP and CCT were statistically significantly associated with selected perinatal characteristics; however, the effect sizes were small. These findings are descriptive and hypothesis-generating and are intended primarily to inform contextual interpretation of ocular measurements in preterm populations. SUPPLEMENTARY INFORMATION: The online version contains supplementary material available at 10.1186/s12886-026-04835-4.