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Refractive errors and ocular motility disorders in preterm babies with and without retinopathy of prematurity
1Department of Ophthalmology, Catholic University, Rome, Italy.
Insights
Preterm infants born before 32 weeks gestation with retinopathy of prematurity (ROP) and those treated with cryotherapy showed higher rates of strabismus and myopia. However, most infants achieved good visual acuity (VA).
Area of Science:
- Ophthalmology
- Neonatology
- Developmental Pediatrics
Background:
- Preterm infants, particularly those born before 32 weeks gestational age (GA), are at increased risk for visual impairments.
- Retinopathy of prematurity (ROP) is a significant concern in this population, potentially leading to long-term visual deficits.
Purpose of the Study:
- To evaluate ocular motility, refraction, and visual acuity (VA) in preterm infants at age 4 years.
- To determine the association between prematurity, ROP (including spontaneous regression and cryotherapy treatment), and visual outcomes.
Main Methods:
- A cohort of 136 preterm infants (GA < 32 weeks) was assessed at 4 years of age.
- Infants were categorized into three groups: non-ROP, regressed ROP, and cryotherapy-treated ROP (cryo-ROP).
- Ocular motility (strabismus), refractive error (myopia, hypermetropia), and VA (using the E chart) were evaluated.
Main Results:
- Strabismus was observed in 13.9% of infants and was significantly associated with lower GA (<29 weeks), ROP, and cryotherapy (p < 0.01).
- High myopia (>3 diopters) was significantly more prevalent in the cryo-ROP group compared to the other groups (p < 0.001).
- Overall, 92.3% of eyes achieved VA > 20/25, with the majority from the non-ROP group; severe visual impairment (<20/60) was rare.
Conclusions:
- Prematurity, ROP, and cryotherapy are risk factors for strabismus and myopia in early childhood.
- Despite these risks, the majority of preterm infants, even those with treated ROP, achieve good visual acuity by age 4.
- Cryotherapy for severe ROP did not preclude the development of good visual acuity.
Abstract:
Ocular motility, refraction and visual acuity (VA) were evaluated at the age of 4 years in 136 preterm infants with gestational ages (GAs) at birth of less than 32 weeks. Group 1 (non-retinopathy of prematurity, ROP) included 87 children that had never developed ROP. Group 2 contained 19 children whose ROP had regressed spontaneously. Group 3 (cryo-ROP) was composed of 30 patients who had undergone cryotherapy for severe ROP. Strabismus was found in 13.9% of the total population. chi(2) analysis revealed that strabismus was significantly (p < 0.01) associated with prematurity (i.e. GA <29 weeks), ROP and cryotherapy. Myopia of more than 3 dpt was significantly (p < 0.001) more common in the cryo-ROP infants than in the regressed-ROP and non-ROP groups. The distribution of hypermetropia was similar in all three groups. VA was measured with the E chart. Of the 272 eyes examined, 251 (92.3%) displayed VA of more than 20/25. The majority of these eyes were from the non-ROP group (65.4%), 15.3% had regressed ROP and 21.1% belonged to the cryo-ROP group. Fifteen eyes (8 non-ROP, 3 regressed ROP and 4 cryo-ROP) presented VAs between 20/25 and 20/60. VA of less then 20/60 was found in 6 eyes (2 non-ROP, 1 regressed ROP, 3 cryo-ROP). Cryotherapy did not appear to preclude the development of good VA.