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Long-term visual outcomes in extremely low-birth-weight children (an American Ophthalmological Society thesis)
1Texas Retina Associates, Retina Foundation of the Southwest and Department of Ophthalmology, University of Texas Southwestern Medical School, Dallas, Texas, USA.
Insights
Long-term vision in extremely low-birth-weight (ELBW) children is often poor, with many experiencing subnormal acuity. Early vision testing can identify ELBW infants at high risk for future visual impairments.
Area of Science:
- Ophthalmology
- Neonatology
- Developmental Pediatrics
Background:
- Extremely low-birth-weight (ELBW) infants face significant health challenges, including potential long-term visual impairments.
- Assessing visual outcomes in this vulnerable population is crucial for early intervention and management.
Purpose of the Study:
- To analyze the long-term visual outcomes in children born with extremely low birth weight.
- To identify risk factors associated with poor visual development in ELBW infants.
Main Methods:
- Retrospective analysis of vision testing data from ELBW children.
- Evaluation of acuity outcomes at over 36 months adjusted age.
- Correlation of early acuity testing with final visual outcomes and assessment of adverse risk factors.
Main Results:
- 54% of ELBW infants had below-normal grating acuities and 66% had below-normal recognition acuities.
- Abnormal early acuity testing and slower visual development predicted long-term visual abnormalities.
- Risk factors included retinopathy of prematurity, gestational age ≤28 weeks, and poorer general health.
Conclusions:
- Long-term visual development in ELBW infants is frequently problematic, with a high risk of subnormal acuity.
- Early acuity testing effectively identifies ELBW children at risk for visual abnormalities.
- Gestational age at birth of ≤28 weeks is a significant risk factor for abnormal long-term visual outcomes.
Purpose:
The goal is to analyze the long-term visual outcome of extremely low-birth-weight children.
Methods:
This is a retrospective analysis of eyes of extremely low-birth-weight children on whom vision testing was performed. Visual outcomes were studied by analyzing acuity outcomes at >/=36 months of adjusted age, correlating early acuity testing with final visual outcome and evaluating adverse risk factors for vision.
Results:
Data from 278 eyes are included. Mean birth weight was 731g, and mean gestational age at birth was 26 weeks. 248 eyes had grating acuity outcomes measured at 73 +/- 36 months, and 183 eyes had recognition acuity testing at 76 +/- 39 months. 54% had below normal grating acuities, and 66% had below normal recognition acuities. 27% of grating outcomes and 17% of recognition outcomes were /=3 years of age. A slower-than-normal rate of early visual development was predictive of abnormal grating acuity (P < .0001) and abnormal recognition acuity (P < .0001) at >/=3 years of age. Eyes diagnosed with maximal retinopathy of prematurity in zone I had lower acuity outcomes (P = .0002) than did those with maximal retinopathy of prematurity in zone II/III. Eyes of children born at 28 weeks gestational age. Eyes of children with poorer general health after premature birth had a 5.3 times greater risk of abnormal recognition acuity.
Conclusions:
Long-term visual development in extremely low-birth-weight infants is problematic and associated with a high risk of subnormal acuity. Early acuity testing is useful in identifying children at greatest risk for long-term visual abnormalities. Gestational age at birth of
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