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Refractive errors and strabismus in premature Asian infants with and without retinopathy of prematurity
1Singapore National Eye Centre, 11 Third Hospital Avenue, Singapore 168751.
Insights
Premature infants with retinopathy of prematurity (ROP) show higher rates of myopia and strabismus. Early detection and treatment are crucial for managing these ocular complications in high-risk infants.
Area of Science:
- Ophthalmology
- Neonatology
- Public Health
Background:
- Retinopathy of prematurity (ROP) is a significant concern in premature infants.
- Previous studies in Caucasian populations suggest a link between ROP and later refractive errors and strabismus.
- The prevalence of these complications in Asian premature infants requires specific investigation.
Purpose of the Study:
- To determine the incidence of refractive errors and strabismus in Asian premature infants.
- To compare complication rates between premature infants with and without ROP.
- To assess the long-term ocular outcomes up to three years of age.
Main Methods:
- Retrospective case review of premature infants (<34 weeks gestation, <1500g birth weight) from 1991-1993.
- Standardized ophthalmology examinations including cycloplegic refraction and fundus examination.
- Follow-up assessments conducted until three years of age to monitor ROP, refractive errors, and strabismus.
Main Results:
- 16.2% of 113 reviewed neonates developed ROP, with higher risk associated with lower birth weight and earlier gestational age.
- At 1-year follow-up, myopia rates were significantly higher in the ROP group (33.3%) compared to the no-ROP group (3.7%).
- Strabismus rates were higher at 1 year in the ROP group (20%) versus no-ROP (4.9%), though not significant at later follow-ups.
Conclusions:
- Premature infants with ROP exhibit increased rates of myopia and, initially, strabismus.
- Long-term ophthalmological follow-up is essential for timely diagnosis and management of ocular issues in these infants.
- Findings highlight the importance of ROP screening and management in Asian premature populations.
Aim:
In Caucasian populations, premature infants with retinopathy of prematurity (ROP) have been reported to have higher risks of developing refractive errors and strabimus. The purpose of this study is to evaluate the rate of these complications in Asian premature infants with and without ROP.
Methods:
A retrospective case review of all premature infants referred to the Singapore National Eye Centre for ophthalmology screening. These included all neonates born earlier than 34 weeks gestational age and less than 1500 grams in birth weight. Standardized ophthalmology examinations including cycloplegic refraction and fundus examination at regular intervals were performed to determine the presence of ROP, refractive errors, squints and other ocular abnormalities until the patients were 3 years old.
Results:
During 1991 to 1993, a total of 113 neonates were reviewed. Of these, 16 (14.2%) developed ROP. The risk of ROP was higher with lower birth weights and earlier gestational ages. At 1-year follow-up, the rate of myopia was 33.3% in babies with ROP compared to 3.7% in babies with no ROP (p < 0.001). The higher rates of myopia in babies with ROP remained with longer follow-up (33.3% and 25% in ROP group versus 3.4% and 3.8% in no ROP group, at 2 and 3 years respectively). There was no difference in rates of astigmatism or hyperopia throughout the 3 years. At 1 year follow-up, the rate of strabismus was 20% in the ROP group compared to 4.9% in the no ROP group (p = 0.07). However, this difference in rates of strabismus was not significant at 2 and 3 years of follow-up.
Conclusion:
Premature babies with ROP had higher rates of myopia and strabismus than those without ROP. Long-term follow-up of these babies is important for early detection and treatment of these ocular problems.