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Ocular growth and refractive error development in premature infants without retinopathy of prematurity
Anne Cook1, Sarah White, Mark Batterbury
1Manchester Royal Eye Hospital, Manchester, United Kingdom. cookydoc@hotmail.com
Insights
Refractive error in premature infants develops with linear growth in axial length and anterior chamber depth, but a complex corneal curvature pattern. These factors influence refractive status, leading to less hyperopia than in full-term infants.
Area of Science:
- Ophthalmology
- Pediatric Medicine
- Developmental Biology
Background:
- Refractive error (RE) is a significant concern in infant eye development.
- Understanding refractive error progression in premature infants is crucial for early intervention.
- This study focuses on premature infants without retinopathy of prematurity (ROP).
Purpose of the Study:
- To investigate the factors contributing to refractive error (RE) development in premature infants.
- To analyze ocular component growth patterns in premature infants.
- To compare ocular development in premature infants to full-term infants.
Main Methods:
- Recruited premature infants from a national ROP screening program.
- Measured axial length (AXL), anterior chamber depth (ACD), lens thickness (LT), and corneal curvature (CC) at multiple postmenstrual ages.
- Utilized multilevel modeling to analyze growth rates and relationships between variables.
Main Results:
- Axial length (AXL) and anterior chamber depth (ACD) exhibited linear growth.
- Corneal curvature (CC) showed a quadratic growth pattern and correlated with refractive state.
- Premature infants transitioned from myopic to hyperopic states, with less hyperopia than expected.
Conclusions:
- Ocular component growth in premature infants is largely linear, except for corneal curvature.
- Corneal curvature plays a key role in refractive state development.
- Premature infants have distinct ocular dimensions (shorter AXL, shallower ACD, more curved CC) compared to full-term infants, impacting refractive outcomes.
Purpose:
This investigation studied the factors involved in the development of refractive error (RE) in premature infants unaffected by retinopathy of prematurity (ROP).
Methods:
Premature infants enrolled in the national ROP screening program were recruited and examined at 32, 36, 40, 44, and 52 weeks' postmenstrual age. At each examination, axial length (AXL), anterior chamber depth (ACD), and lens thickness (LT) were measured on the A-scan biometer. Corneal curvature (CC) was recorded with a video-ophthalmophakometer, and refractive state was determined with routine cycloplegic refraction. Multilevel modeling techniques were used to determine the relationships between all the variables throughout the study period, as well as individual growth rates.
Results:
Sixty-eight premature infants were included. AXL and ACD showed linear patterns of growth, whereas LT changed little over the study period. CC showed a quadratic growth pattern, and unlike the previous variables, correlated well with refractive state. Premature infants were myopes at the start of the study, with refraction becoming emmetropic as they neared full term and then hypermetropic toward the end of the study.
Conclusions:
Most of the components of refractive status showed linear patterns of growth during this early phase of ocular development. CC displayed a more complex pattern of growth, which correlated well with refractive state. Compared with full-term infants examined around term, this group has shorter AXLs, shallower anterior chambers, and more highly curved corneas. In addition, less of the expected hypermetropia developed in the premature group, which seems mainly due to the differences in ACD and corneal curvature.