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Ophthalmological follow up of preterm infants: a population based, prospective study of visual acuity and strabismus
G Holmström1, M el Azazi, U Kugelberg
1Department of Ophthalmology, Huddinge University Hospital, Karolinska Institute, Stockholm, Sweden.
Insights
Preterm infants have higher rates of vision problems and strabismus. Early screening for retinopathy of prematurity (ROP) and follow-up are recommended for these vulnerable children.
Area of Science:
- Ophthalmology
- Neonatology
- Pediatrics
Background:
- Premature infants face increased risks of eye conditions.
- Retinopathy of prematurity (ROP) is a known complication.
Purpose of the Study:
- To assess visual acuity and ocular alignment in preterm infants.
- To compare outcomes in infants with and without ROP.
Main Methods:
- Prospective, population-based study of preterm infants (birth weight ≤ 1500g).
- Ophthalmological examinations at 6, 18, 30, and 42 months corrected age.
- Visual acuity testing and strabismus assessment; multiple regression analysis for risk factors.
Main Results:
- 2.5% had poor vision (<0.3), 0.8% severe visual impairment (<0.1).
- Strabismus affected 13.5% of infants.
- Children with cryotreated ROP or neurological complications had higher risks of poor vision and strabismus.
Conclusions:
- Subnormal vision and strabismus incidence is higher in preterm infants compared to full-term infants.
- Recommended follow-up for all preterm infants screened for ROP.
- General guidelines for preterm infant eye care are suggested.
Background/Aims:
Prematurely born infants are known to have an increased rate of ophthalmological morbidity. The aim of the present study was to investigate visual acuity and ocular alignment in a population of preterm infants in a geographical area, in infants with and without retinopathy of prematurity (ROP).
Methods:
A prospective population based study of ophthalmological status of preterm infants with a birth weight of 1500 g or less was performed during 3.5 years, with examinations at 6, 18, 30, and 42 months of corrected age. Visual acuity was tested using linear optotypes. Multiple regression analyses were used to analyse independent risk factors for poor vision and strabismus.
Results:
Poor vision (< 0.3) was detected in 2.5% (6/237) of the children. Of these, only two (0.8%) had a severe visual impairment (< 0.1). Strabismus occurred in 13.5% (31/229). Children with cryotreated ROP and neurological complications ran the highest risk of poor vision and strabismus, according to multiple regression analysis. Among children without a history of ROP or neurological complications, 34% had a visual acuity < 0.7 and 5.9% had strabismus, compared with 61% and 22%, respectively, among the children with ROP or neurological complications.
Conclusions:
The overall incidence of subnormal vision and strabismus in children born prematurely was higher than in a full term population of the same age. On the basis of this study, follow up of all preterm infants screened for ROP is recommended and general guidelines are suggested.