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Refractive Status in Nepalese Pre-Term and Full-Term Infants Early in Life
Samir Uprety1, Priya Morjaria, Jyoti B Shrestha
11College of Optometry, Southwestern University, Cebu City, Philippines 2Faculty of Infectious Tropical Diseases, Department of Clinical Research, London School of Hygiene and Tropical Medicine, London, United Kingdom 3BP Koirala Lions Center for Ophthalmic Studies, Institute of Medicine, Kathmandu, Nepal 4School of Optometry and Vision Science, Faculty of Medical and Health Science, University of Auckland, Auckland, New Zealand *Contributed equally to this work †s.khanal@auckland.ac.nz.
Insights
Pre-term infants without retinopathy of prematurity (ROP) show a trend toward myopia and increased astigmatism within six months. Close monitoring of refractive error is crucial for these infants.
Area of Science:
- Ophthalmology
- Neonatal Care
- Developmental Pediatrics
Background:
- Infant refractive error development is influenced by prematurity.
- Retinopathy of prematurity (ROP) is a known risk factor for visual impairment in pre-term infants.
- The refractive status of pre-term infants without ROP requires further investigation.
Purpose of the Study:
- To investigate refractive error trends in Nepalese pre-term infants without ROP during the first six months of life.
- To explore associations between refractive error, birth weight (BW), and gestational age (GA) in pre-term infants.
- To compare refractive development between pre-term and full-term infants.
Main Methods:
- Cycloplegic retinoscopy was performed on 36 pre-term and 40 full-term infants at birth, term (pre-term only), 3, and 6 months.
- Refractive status was categorized into emmetropia, myopia, and significant hyperopia based on spherical equivalent refraction (SER).
- General linear model repeated measures ANOVA was used to compare refractive parameters between groups.
Main Results:
- Pre-term infants showed a shift towards myopia by 6 months (SER = -0.33 ± 1.95D) compared to birth (SER = +0.84 ± 1.72D).
- Significant differences in SER, astigmatism, and anisometropia were observed between pre-term and full-term infants by 6 months (P < .01).
- Astigmatism and anisometropia increased with age in pre-term infants, unlike full-term infants.
Conclusions:
- Pre-term infants without ROP exhibit a trend towards myopia and greater astigmatism and anisometropia compared to full-term infants in the first six months.
- Gestational age positively correlated with SER, while birth weight negatively correlated with astigmatism in pre-term infants.
- Close monitoring of refractive error is essential for pre-term infants, irrespective of ROP status.
Significance:
This study suggests that pre-term infants, even without retinopathy of prematurity, are at risk for abnormal refractive development and informs the need for close monitoring of refractive error in such infants, regardless of their retinopathy of prematurity status.
Purpose:
The present study aims to investigate the refractive error trend in Nepalese pre-term infants without retinopathy of prematurity (ROP) in the first 6 months of life and explore the association of refractive error with birth weight (BW) and gestational age (GA).
Methods:
Thirty-six pre-term infants without ROP and 40 full-term infants underwent cycloplegic retinoscopy at birth, term (for pre-term only), 3 months, and 6 months chronologically. Refractive status was classified into emmetropia (mean spherical equivalent refraction [SER] 0 to +3.00D), myopia (SER < 0.00D), and significant hyperopia (SER > +3.00D). Refractive parameters at various age points were compared between the pre-term and full-term infants using general linear model repeated measures ANOVA.
Results:
At birth, the SER in the pre-term infants was +0.84 ± 1.72D; however, there was a shift toward myopia at 6 months of age (SER = -0.33 ± 1.95D). There was a significant difference in SER, astigmatism, and anisometropia between pre-term and full-term infants by 6 months of age (P < .01). Astigmatism and anisometropia showed an increasing trend with age in pre-term infants (P < .05 at 6 months) in contrast to a decreasing trend in full-term infants (P < 0.05 at 3 and 6 months). In pre-term infants, there was a statistically significant positive relationship between GA and SER (β = 0.32, R = 17.6%, P < .05) but a negative relationship between BW and astigmatism (β = -1.25, R = 20.6%, P < .01).
Conclusions:
Pre-term infants who do not develop ROP show a trend toward increasing myopia and demonstrate greater astigmatism and anisometropia than full-term infants in their first 6 months of life.
