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Long-term evaluation of refractive status and optical components in eyes of children born prematurely
Ta-Ching Chen1, Tzu-Hsun Tsai, Yung-Feng Shih
1Department of Ophthalmology, National Taiwan University Hospital, Taipei, Taiwan.
Insights
Children born prematurely have higher rates of myopia, hyperopia, and astigmatism due to specific optical component changes. Retinopathy of prematurity (ROP) is linked to more severe ocular alterations and refractive errors.
Area of Science:
- Ophthalmology
- Pediatric Ophthalmology
- Refractive Error Research
Background:
- Premature birth is a significant risk factor for visual impairments in children.
- Understanding the optical components and refractive status in this population is crucial for early intervention.
Purpose of the Study:
- To evaluate refractive status and optical components in school-aged children born prematurely.
- To identify risk factors associated with refractive errors in this cohort.
Main Methods:
- A cohort of 7-9 year olds born before 35 weeks gestation or with birth weight <1500g was studied.
- Neonatal histories were reviewed, and refractive status/optical components were measured.
- Results were compared to age-matched controls from a national survey.
Main Results:
- Children born prematurely showed higher prevalence of myopia (48%), hyperopia (23%), and astigmatism (73%) compared to controls.
- Common features included shallow anterior chamber depth (ACD), thick lenses, and steep corneal curvature.
- History of retinopathy of prematurity (ROP) correlated with shorter axial length (AL), shallower ACD, thicker lenses, and increased myopia/astigmatism.
Conclusions:
- Myopia in premature children is linked to anterior segment components; hyperopia to short axial length (AL).
- Astigmatism is primarily cornea-related.
- Retinopathy of prematurity (ROP) is associated with significant ocular changes and complex refractive errors.
Purpose:
To evaluate the refractive status and optical components in school age children born prematurely and to examine the risk factors associated with refractive errors.
Methods:
The participants were a cohort of children aged 7 to 9 years with gestational age less than 35 weeks or birth weight less than 1500 g. The participants' neonatal histories were reviewed; their refractive status and optical components were measured. The study results were compared with the results of age-matched children from a national survey.
Results:
Of the 108 children studied, 48 (44%) had retinopathy of prematurity (ROP); 29 (27%) had ROP ≥ stage 3. Compared with the control subjects, the study cases showed higher prevalence of myopia (48% vs. 29%), hyperopia (23% vs. 15%), and astigmatism (73% vs. 41%). Common ocular features included shallow anterior chamber depth (ACD), thick lenses, and steep corneal curvature. The hyperopic cases had the shortest axial length (AL), whereas the myopia cases had significantly shallower ACD and greater LT. Those with a history of ROP had more prominent changes in the anterior segment. Generalized estimating equations showed that refractive errors could be predicted by a combination of optical components.
Conclusions:
In children born prematurely, the development of myopia is mainly influenced by anterior segment components, whereas hyperopia is mainly attributable to short AL. Astigmatism is primarily cornea-related. A combination of various optical components results in complicated refractive outcomes. The presence of ROP may be associated with significantly shorter ACD, thicker lens, and higher myopia and astigmatism. (ClinicalTrials.gov number, NCT01045616.).
