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Ocular alignment and refraction in preterm children at 1 and 6 years old

Muna Al Oum1, Simone Donati1, Luigi Cerri1

  • 1Department of Surgical and Morphological Sciences, Section of Ophthalmology, School of Medicine, University of Insubria, Varese, Italy.

Clinical Ophthalmology (Auckland, N.Z.)
|July 26, 2014
PubMed

Insights

Preterm children, especially those with retinopathy of prematurity (ROP), show higher rates of myopia and strabismus. Ocular alignment and refractive errors in preterm infants require ongoing monitoring due to potential developmental changes.

Area of Science:

  • Ophthalmology
  • Neonatology
  • Pediatric Medicine

Background:

  • Preterm birth is associated with an increased risk of visual impairments.
  • Retinopathy of prematurity (ROP) is a significant concern in preterm infants, potentially leading to long-term ocular complications.

Purpose of the Study:

  • To evaluate cycloplegic refraction and ocular alignment in preterm children at 1 and 6 years of age.
  • To compare ocular outcomes between preterm infants with and without ROP, and to assess the impact of ROP severity.

Main Methods:

  • A cohort of 261 preterm infants (birth weight ≤1,500 g, gestational age ≤32 weeks) was studied.
  • Participants were categorized into three groups: no ROP (n=217), mild ROP (n=28), and severe ROP (n=16).
  • Ophthalmological examinations including retinoscopy, ocular alignment assessment, and fundus examination were performed at 1 and 6 years old.

Main Results:

  • At 1 year, groups with mild and severe ROP showed higher myopia (18%, 40.6%) and strabismus (12.5%, 38%) rates compared to the no-ROP group (6.9%, 5.3%).
  • By 6 years, myopia rates increased in all groups, with severe ROP still showing significantly higher rates (28.4%). Strabismus rates also increased, particularly in the severe ROP group (56.25%).
  • Hyperopia rates were higher in the no-ROP group at 1 year (39.2%) but showed increases in other groups by 6 years (48.3%, 40.5%). Astigmatism prevalence varied but was not consistently higher in ROP groups at 6 years.

Conclusions:

  • Preterm children, particularly those with ROP, exhibit elevated risks for myopia and strabismus, with severity correlating to ROP stage.
  • Hyperopia and strabismus rates increased from 1 to 6 years across all preterm groups.
  • Early astigmatism in preterm infants at 1 year does not reliably predict its progression, highlighting the need for continued monitoring of refractive and alignment changes.
Abstract

Keywords:
refraction strabismusretinopathy of prematurityvision screeningvisual impairment

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