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Published on: April 2, 2021
Impact of retinopathy of prematurity on ocular structures and visual functions
Alistair Fielder1, Hannah Blencowe2, Anna O'Connor3
1Division of Optometry & Visual Science, City University, London, UK.
Insights
Premature babies can suffer vision loss from prematurity or retinopathy of prematurity (ROP). Risk factors and visual impairment vary significantly by country income, impacting eye health and visual functions.
Area of Science:
- Ophthalmology
- Neonatology
- Public Health
Background:
- Preterm infants are susceptible to ophthalmic sequelae, including those arising from prematurity itself and retinopathy of prematurity (ROP).
- Neurological damage can also contribute to vision problems in preterm infants.
Purpose of the Study:
- To analyze the ophthalmic sequelae in preterm infants, focusing on prematurity and ROP.
- To present regional and global estimates of ROP and associated visual impairment.
- To discuss the impact of these conditions on eye structure and visual functions.
Main Methods:
- Review and synthesis of existing data on retinopathy of prematurity (ROP) and its consequences.
- Analysis of regional and global estimates of acute-phase ROP and visual impairment.
- Discussion of the effects of prematurity and ROP on ocular morphology and visual functions.
Main Results:
- In high-income countries, sight-threatening ROP primarily affects infants <1000g birth weight (BW).
- In low- and middle-income countries, infants >2500g BW can be blinded by ROP.
- Estimates of ROP and subsequent visual impairment (mild/moderate to severe) are presented regionally and globally.
Conclusions:
- Ophthalmic sequelae in preterm infants, particularly ROP, present a significant global health challenge.
- Disparities in ROP risk and severity exist between high-income and low-/middle-income countries.
- These conditions affect ocular development, leading to strabismus and impaired visual functions like acuity and visual field.
Abstract:
The preterm baby may develop ophthalmic sequelae which can be due to prematurity per se, due to retinopathy of prematurity (ROP) or due to neurological damage. Focusing on the former two, we discuss how in high-income countries the risk of sight-threatening ROP is largely confined to babies <1000 g birth weight (BW), whereas in low-income or middle-income countries babies exceeding 2500 g BW can be blinded. The effects of prematurity and ROP are presented as regional and global estimates of acute-phase ROP and the consequent mild/moderate and severe visual impairment. We discuss sequelae and how they affect the eye and its shape, strabismus and finally consider their impact on visual functions, including visual acuity, the visual field, colour vision and contrast sensitivity.
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