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[Visual future of prematures]
Insights
Premature children born with low birth weight exhibit significant retinal abnormalities, including pigmentary changes and vascular issues. These findings are linked to a high prevalence of myopia, necessitating long-term monitoring for potential vision complications.
Area of Science:
- Ophthalmology
- Neonatology
- Developmental Pediatrics
Context:
- Premature infants are at increased risk for various ocular complications.
- Low birth weight (<1,500g) is a significant risk factor for retinopathy of prematurity and associated visual impairments.
- Longitudinal studies are crucial for understanding the long-term visual outcomes in this vulnerable population.
Purpose:
- To investigate retinal periphery abnormalities in premature children aged 5-8 years with birth weights ≤1,500g.
- To identify the prevalence and types of retinal anomalies, including pigmentary, vascular, and vitreous abnormalities.
- To assess the refractive status, specifically myopia, and its characteristics in this cohort.
Summary:
- Retinal periphery examination in 60 premature children (birth weight ≤1,500g) revealed pigmentary modifications (20%), vascular abnormalities (14%), and vitreous abnormalities (12%).
- Potential complications like retinal tear, retinoschisis, and detachment were noted, emphasizing the need for vigilance even with subtle signs.
- Refraction studies identified myopia in 30% of children, with a significant subgroup having high myopia (≥8 diopters), characterized by its constancy, importance, and minimal evolution.
Impact:
- Highlights the persistent ocular risks associated with prematurity and low birth weight.
- Underscores the importance of regular ophthalmological follow-up for early detection and management of visual complications in premature infants.
- Provides insights into the unique characteristics of myopia in premature children, aiding in prognosis and management strategies.
Abstract:
The retinal periphery of 60 premature children now between 5 and 8 years of age and with a weight at birth equal or less than 1,500 g has been investigated. In 20% of these children, pigmentary modifications were noted which were often associated with chorioretinal atrophy. Polymorphic vascular abnormalities were seen in 14% of the cases, i.e. sinuous vessels of irregular caliber or neovascularization. Abnormalities of the vitreous body were also noted in 12% of the patients with glial bags on the periphery and sometimes potentially dangerous tractions folds (4%). All these abnormalities could cause complications such as retinal tear, retinoschisis or retinal detachment. Even if these signs are discrete, they can later on be the source of complications. Refraction studies revealed 30% of myopic children. The most important group had myopias equal or higher than 8 d. The characteristics of the myopia of premature children are its constancy (all premature children are myopic at birth); its importance (it depends on birth weight and on the severity of the retinopathy), and its evolution (the myopia of premature children does not evolve or evolves very slightly).