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Development of astigmatism and anisometropia in preterm children during the first 10 years of life: a
Eva K Larsson1, Gerd E Holmström
1Department of Ophthalmology, Uppsala University Hospital, Uppsala, Sweden. eva.larsson@ogon.uu.se
Insights
Refraction in preterm children at 2.5 years old predicts later astigmatism and anisometropia. Early screening is crucial for detecting vision issues in school-aged children.
Area of Science:
- Ophthalmology
- Pediatric Optometry
- Developmental Pediatrics
Background:
- Preterm infants are at higher risk for visual impairments.
- Retinopathy of prematurity (ROP) is a significant concern in preterm infants.
- Long-term visual development, including refractive errors, requires ongoing assessment.
Purpose of the Study:
- To evaluate the progression of astigmatism and anisometropia up to 10 years of age in children born preterm.
- To identify risk factors for developing these refractive errors in this population.
- To determine the predictive value of early refractive assessments.
Main Methods:
- A cohort of 198 preterm children underwent cycloplegic retinoscopies at 6 months, 2.5 years, and 10 years of age.
- Astigmatism and anisometropia were defined as 1 diopter (D) or more.
- Statistical analyses, including multiple regression, were used to identify risk factors.
Main Results:
- Astigmatism decreased from 6 months to 2.5 years, then stabilized; ROP stage did not influence this trend.
- Anisometropia increased in amount but not prevalence.
- Astigmatism at 2.5 years and cryotreated severe ROP were risk factors for astigmatism at 10 years.
- Anisometropia of 2 D or more at 2.5 years predicted anisometropia at 10 years.
Conclusions:
- Astigmatism and anisometropia development followed similar patterns irrespective of ROP stage.
- Refraction at 6 months was not predictive of later refractive errors.
- Refraction at 2.5 years was a valuable predictor for astigmatism and anisometropia at 10 years.
- Routine retinoscopy around 2.5 years may help identify persistent school-age visual issues in preterm children.
Objective:
To assess the development of astigmatism and anisometropia to 10 years of age in preterm children, previously included in a population-based study on the incidence of retinopathy of prematurity.
Methods:
Cycloplegic retinoscopies were performed in 198 preterm children at 6 months, 2(1/2) years, and 10 years of age. We analyzed the development of astigmatism of 1 diopter (D) or more and anisometropia of 1 D or more.
Results:
The amount and prevalence of astigmatism declined between 6 months and 2(1/2) years of age and then remained stable. We found no difference in the course of astigmatism at different ages with regard to stage of retinopathy of prematurity. The amount of anisometropia increased, but its prevalence remained unchanged. Multiple regression analyses showed that astigmatism of 1 D or more at 2(1/2) years of age and cryotreated severe retinopathy of prematurity were risk factors for astigmatism at 10 years of age, and that anisometropia of 2 D or more at 2(1/2) years of age was a risk factor for anisometropia at 10 years of age.
Conclusions:
The development of astigmatism and anisometropia showed a similar course, regardless of stage of retinopathy of prematurity. The retinoscopy findings at 6 months of age were of no value in predicting astigmatism and anisometropia at 10 years of age, but the refraction at 2(1/2) years of age was. Retinoscopy at about 2(1/2) years of age in all preterm children may be useful for detecting astigmatism and anisometropia that will persist in children of school age.
