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Development of spherical equivalent refraction in prematurely born children during the first 10 years of life: a
Gerd E Holmström1, Eva K Larsson
1Department of Ophthalmology, Uppsala University Hospital, Uppsala, Sweden. gerd.holmstrom@ogon.uu.se
Insights
Refractive development in premature children shows similar trends regardless of retinopathy of prematurity stage. Refraction at 2.5 years old is a better predictor of myopia at 10 years than at 6 months.
Area of Science:
- Ophthalmology
- Pediatric Ophthalmology
- Refractive Error Development
Background:
- Premature birth is a risk factor for various ocular conditions, including refractive errors.
- Understanding refractive development in prematurely born children is crucial for early intervention and management.
- Retinopathy of prematurity (ROP) can influence long-term visual outcomes.
Purpose of the Study:
- To evaluate the longitudinal development of refractive error, measured as spherical equivalents, in prematurely born children up to 10 years of age.
- To determine if early refractive measurements can predict later refractive outcomes.
- To assess the impact of retinopathy of prematurity on refractive development.
Main Methods:
- Longitudinal study involving 198 prematurely born children.
- Cycloplegic retinoscopy performed at 6 months, 2.5 years, and 10 years of age.
- Calculation of spherical equivalents to define myopia and hypermetropia.
Main Results:
- No significant differences in refractive development were observed across different stages of retinopathy of prematurity.
- Eyes treated with cryotherapy showed a broader range of refractive errors.
- Spherical equivalents at 2.5 years of age were predictive of clinically significant myopia (≤-1 D) at 10 years of age.
Conclusions:
- Refractive development follows a similar pattern in prematurely born children, irrespective of ROP severity.
- Refraction at 6 months is not a reliable predictor of refractive errors at 10 years.
- Refractive assessment at 2.5 years of age appears to be a valuable tool for identifying children at risk for persistent refractive errors later in childhood.
Objective:
To evaluate the development of refraction, expressed as spherical equivalents, in prematurely born children during the first 10 years of life.
Methods:
Retinoscopy in cycloplegia was performed at 6 months, 2.5 years, and 10 years of age in 198 prematurely born children from a previous population-based study on the incidence of retinopathy of prematurity. Spherical equivalents were calculated. Myopia was defined as a spherical equivalent of less than 0 diopters (D), clinically significant myopia at 10 years of age as -1 D or less, and moderate or high myopia as less than -3D. Hypermetropia greater than +3 D was regarded as significant.
Results:
There were no significant differences during the refractive development between the various subgroups of retinopathy of prematurity. Cryotreated eyes had a wider distribution of refractive errors. A multiple regression analysis revealed that the spherical equivalents at 2.5 years of age predicted clinically significant myopia (
Conclusions:
Retinoscopies at 6 months, 2.5 years, and 10 years of age show a similar course of spherical equivalent refractive development regardless of the stage of retinopathy of prematurity. Refraction at 6 months of age is an unreliable predictor, but the refraction at 2.5 years of age seems to be a better tool for identifying refractive errors that will remain at 10 years of age.
