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Emmetropisation following preterm birth
K J Saunders1, D L McCulloch, A J Shepherd
1School of Biomedical Sciences, University of Ulster, Coleraine, Northern Ireland, BT52 1SA, UK. kj.saunders@ulst.ac.uk
Insights
Premature birth increases the risk of abnormal refractive development, even without retinopathy of prematurity (ROP). Early refractive outcomes in preterm infants without ROP are unpredictable, with high rates of refractive errors by age 4.
Area of Science:
- Ophthalmology
- Developmental Biology
- Pediatrics
Background:
- Premature birth is linked to increased risk of abnormal refractive development, even in the absence of retinopathy of prematurity (ROP).
- Understanding refractive development in preterm infants without ROP is crucial for early intervention and management.
- This study investigates the relationship between clinical risk factors and refractive development in this specific population.
Purpose of the Study:
- To examine the relationship between clinical risk factors and refractive development in preterm infants without ROP.
- To compare refractive development between preterm and full-term infants.
- To identify predictors of refractive outcomes at 4 years of age in preterm infants.
Main Methods:
- Cycloplegic refraction was measured at multiple time points (birth, term, 6, 12, 48 months corrected age) in 59 preterm infants.
- Perinatal history and cranial ultrasound data were collected.
- A control group of 40 full-term infants was also studied.
Main Results:
- Preterm infants without ROP exhibited higher rates of myopia and anisometropia compared to full-term infants.
- While early emmetropization occurred, preterm infants remained more myopic at term age.
- Infants born weighing <1500g had persistent anisometropia, and abnormal cranial ultrasounds were linked to higher hyperopia.
- Nineteen percent of preterm infants had clinically significant refractive errors by 4 years of age.
Conclusions:
- Preterm infants without ROP demonstrate distinct early emmetropization patterns and high rates of refractive error.
- Neither clinical risk factors nor early refractive error measures reliably predicted refractive outcomes at 4 years.
- Further research is needed to understand long-term visual outcomes and potential interventions for preterm infants.
Background/Aims:
Even in the absence of retinopathy of prematurity (ROP), premature birth signals increased risk for abnormal refractive development. The present study examined the relation between clinical risk factors and refractive development among preterm infants without ROP.
Methods:
Cycloplegic refraction was measured at birth, term, 6, 12, and 48 months corrected age in a cohort of 59 preterm infants. Detailed perinatal history and cranial ultrasound data were collected. 40 full term (plus or minus 2 weeks) subjects were tested at birth, 6, and 12 months old.
Results:
Myopia and anisometropia were associated with prematurity (p<0.05). More variation in astigmatic axis was found among preterm infants (p<0.05) and a trend for more astigmatism (p<0.1). Emmetropisation occurred in the preterm infants so that at term age they did not differ from the fullterm group in astigmatism or anisometropia. However, preterm infants remained more myopic (less hyperopic) than the fullterm group at term (p<0.05) and those infants born <1500 g remained more anisometropic than their peers until 6 months (p<0.05). Infants with abnormal cranial ultrasound were at risk for higher hyperopia (p<0.05). Other clinical risk factors were not associated with differences in refractive development. At 4 years of age 19% of the preterm group had clinically significant refractive errors.
Conclusion:
Preterm infants without ROP had high rates of refractive error. The early emmetropisation process differed from that of the fullterm group but neither clinical risk factors nor measures of early refractive error were predictive of refractive outcome at 4 years.