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A population-based study of the refractive outcome in 10-year-old preterm and full-term children
Eva K Larsson1, Agneta C Rydberg, Gerd E Holmström
1Department of Ophthalmology, Uppsala University Hospital, Uppsala, and Karolinska Institutet, Stockholm, Sweden.
Insights
Ten-year-old children born prematurely have significantly higher rates of refractive errors, including myopia and astigmatism, compared to full-term controls. Cryotreated premature infants faced the highest risk, underscoring the need for comprehensive eye exams.
Area of Science:
- Ophthalmology
- Pediatric Medicine
- Public Health
Background:
- Premature birth is a known risk factor for various health complications, including visual impairments.
- Refractive errors in childhood can impact visual development and academic performance.
- Understanding long-term refractive outcomes in preterm children is crucial for early intervention.
Purpose of the Study:
- To compare refractive outcomes at age 10 between children born prematurely and those born at full term.
- To identify specific refractive errors prevalent in prematurely born children.
- To assess the influence of neonatal treatments like cryotherapy on refractive outcomes.
Main Methods:
- A population-based study involving retinoscopy under cycloplegia in 213 prematurely born children and 217 full-term controls at age 10.
- Analysis of spherical equivalent, astigmatism, anisometropia, and significant refractive errors (defined by specific diopter thresholds).
- Comparison of refractive error prevalence between preterm and full-term groups, with a subgroup analysis of cryotreated preterm infants.
Main Results:
- Significant refractive errors were found in 29.6% of prematurely born children versus 7.8% of full-term controls, a fourfold increase.
- Prematurely born children exhibited higher prevalences of hypermetropia (>3 D), myopia (≤-1 D), astigmatism (≥1 D), and anisometropia (≥1 D).
- Among preterm infants, those treated with cryotherapy showed the highest risk (64%) for myopia, astigmatism, and anisometropia.
Conclusions:
- Prematurity is independently associated with a significantly higher risk of refractive errors at age 10.
- Neonatal cryotherapy in preterm infants is linked to an increased prevalence of specific refractive errors.
- Ophthalmological follow-up for prematurely born children is essential, even in the absence of retinopathy of prematurity during the neonatal period.
Objective:
To evaluate the refractive outcome in 10-year-old prematurely born children and in full-term control children.
Methods:
Retinoscopy during cycloplegia was performed in 213 prematurely born children from a previous population-based study on the incidence of retinopathy of prematurity and in 217 children born at term. The spherical equivalent, astigmatism, anisometropia, and significant refractive errors (defined as hypermetropia >3 diopters [D], myopia < or =-1 D, astigmatism > or =1 D in 1 or both eyes, and/or anisometropia > or =1 D) were analyzed.
Results:
Significant refractive errors were found in 29.6% of the prematurely born and in 7.8% of the full-term children. Prematurely born children had higher prevalences of hypermetropia of more than 3 D, myopia of -1 D or less, astigmatism of 1 D or more, and anisometropia of 1 D or more than those born at term. In the preterm group, the cryotreated children had the greatest risk of refractive errors (16 [64%] of 25 children), with higher prevalences of myopia (<0, < or =-1, or <-3 D), astigmatism (> or =1 D), and anisometropia (> or =1 D).
Conclusions:
Significant refractive errors were 4 times more common in 10-year-old prematurely born children than in full-term controls. Cryotreated children had the highest risk, but prematurity per se was also associated with refractive errors. Ophthalmological follow-up of prematurely born children should, therefore, also include children without retinopathy of prematurity in the neonatal period.
