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Ocular features other than retinopathy of prematurity in the pre-term infant
1Department of Ophthalmology, Frederiksborg County Hospital, Hillerød, Denmark.
Insights
This study followed 218 premature infants, focusing on ocular findings beyond retinopathy of prematurity (ROP). Key observations included retinal hemorrhages, optic disc variations, and refractive errors like myopia in preterm infants.
Area of Science:
- Ophthalmology
- Neonatology
- Developmental Pediatrics
Background:
- Premature infants are at high risk for ocular complications, including retinopathy of prematurity (ROP).
- Understanding the spectrum of ocular findings in preterm infants is crucial for early detection and management.
- This study investigates various ocular parameters in a cohort of preterm infants.
Purpose of the Study:
- To document and analyze ocular findings in premature infants beyond ROP.
- To characterize retinal hemorrhages, optic disc morphology, and refractive states in preterm neonates.
- To identify characteristics associated with myopia of prematurity.
Main Methods:
- Longitudinal follow-up of 218 premature infants born between 1985-1987.
- Ophthalmic examinations focusing on retinal hemorrhages, optic disc shape and cup, and refractive error.
- Assessment of refractive state at various post-conceptional ages.
Main Results:
- 11 cases of long-standing retinal hemorrhages and 3 cases of vitreous bleeding were observed.
- Oval optic discs and the presence of optic disc cups were noted as preterm findings.
- Myopia was prevalent at post-conceptional ages <40 weeks, shifting towards hypermetropia by 2-3 months.
- Four cases met criteria for myopia of prematurity, defined by early ROP and persistent myopia (>18-24 months).
Conclusions:
- Premature infants exhibit distinct ocular characteristics, including specific optic disc morphologies and refractive patterns.
- Myopia is common in preterm infants, with a subset developing persistent myopia of prematurity.
- Comprehensive ophthalmic assessment is vital for preterm infants to detect and manage potential visual impairments.
Abstract:
218 premature infants born 1985-87 in Frederiksborg County were followed in the eye clinic, mainly due to the risk of developing retinopathy of prematurity (ROP). The median gestational age was 33 weeks, the median birth weight 1.750 g. ROP being analysed elsewhere, emphasis is on a) retinal haemorrhages (long-standing in 11) and vitreous bleeding (3 cases); b) the oval shape of the pre-term optic disc, considered a true finding and not merely an optical artifact; c) the pre-term presence of the optic disc cup, otherwise considered of about-term development; and d) refractive state, with myopia as a prevailing finding at post-conceptional ages shorter than 40 weeks. A shift towards hypermetropia became obvious after 2-3 months. Only 4 cases deserved the label myopia of prematurity, the criteria being early recording of ROP and persistent myopia (for more than 18-24 months).