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Infantile esotropia in very low birth weight (VLBW) children
J W Pott1, D T Sprunger, E M Helveston
1Department of Ophthalmology, University Hospital, Groningen, The Netherlands.
Insights
Very low birth weight (VLBW) children have high rates of early strabismus, but infantile esotropia is uncommon. Other ophthalmological conditions, not cerebral damage, typically cause strabismus in VLBW infants.
Area of Science:
- Ophthalmology
- Neonatology
- Pediatric Neurology
Background:
- Very low birth weight (VLBW) infants exhibit a high incidence of early-onset strabismus.
- This is often associated with pre- and perinatal cerebral disturbances in VLBW neonates.
- The specific characteristics of strabismus in VLBW children, particularly infantile esotropia, remain unclear.
Purpose of the Study:
- To investigate whether early-onset strabismus in VLBW children presents with characteristics of infantile esotropia.
- To determine the potential role of acquired cerebral damage in the pathogenesis of strabismus in this population.
Main Methods:
- Retrospective chart review of 265 VLBW children.
- Analysis of strabismus prevalence and type.
- Assessment of follow-up duration and ophthalmological findings.
Main Results:
- Strabismus was identified in 20.7% of VLBW children.
- Only 1.9% showed clear characteristics of infantile esotropia; an additional 3.0% possibly did.
- The majority of strabismus cases (42 children) were attributed to ophthalmological disorders like ROP, optic nerve atrophy, or cortical blindness.
Conclusions:
- VLBW children are at increased risk for early-onset strabismus.
- Infantile esotropia is not a typical presentation of strabismus in VLBW infants.
- Early acquired cerebral damage may not be a primary factor in the development of infantile esotropia in this cohort.
Abstract:
VLBW children are known to have a high frequency of early onset strabismus, which is related to the high prevalence of pre- and perinatal cerebral disturbances reported in these children. It is unknown if the early onset strabismus in VLBW children has the characteristics of infantile esotropia. If so, then (acquired) cerebral damage may play an important role in the origin of this type of strabismus. For this reason, the charts of 265 VLBW children were retrospectively reviewed. Strabismus was present in 55 (20.7%) children. Mean follow-up was 75 weeks, with 29.8% of the children having a follow-up of less then 6 months. Only 5 children (1.9%) with characteristics of infantile esotropia could be identified. Another 8 children (3.0%) possibly had infantile esotropia, but follow-up had been too infrequent during the first year of life to determine the time of onset of strabismus precisely. The other 42 children with strabismus all had ophthalmological disorders (i.e. ROP, optic nerve atrophy, cortical blindness) explaining early disruption of binocular visual development. Therefore, VLBW children are at risk for early onset strabismus. However, infantile esotropia is not typical for VLBW children and may be an indication that early acquired cerebral damage does not play an important role in the pathogenesis of infantile esotropia.