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Corneal Aberrations in Former Preterm Infants: Results From The Wiesbaden Prematurity Study
Achim Fieß1,2, Alexander K Schuster2, Ruth Kölb-Keerl1
1Department of Ophthalmology, Helios Dr. Horst Schmidt Klinik Wiesbaden, Germany.
Insights
Extreme prematurity is linked to increased corneal aberrations in children. Retinopathy of prematurity (ROP) did not show an association with these visual impairments.
Area of Science:
- Ophthalmology
- Pediatric Ophthalmology
- Corneal Physiology
Background:
- Preterm birth can impact visual development.
- Corneal aberrations may affect visual acuity.
- Understanding these effects is crucial for early intervention.
Purpose of the Study:
- To compare corneal aberrations between former preterm and full-term infants.
- To investigate the association of gestational age and retinopathy of prematurity (ROP) with corneal shape.
Main Methods:
- Prospective cross-sectional study of 4-10 year olds.
- Scheimpflug imaging used to measure corneal aberrations (astigmatism, coma, trefoil, spherical aberration, RMS HOA).
- Multivariable analysis adjusted for sex and age.
Main Results:
- Extreme prematurity (gestational age ≤28 weeks) associated with higher-order and lower-order corneal aberrations.
- Vertical coma was significantly higher in extremely preterm infants.
- No association found between ROP and corneal aberrations after adjusting for gestational age.
Conclusions:
- Corneal aberrations are linked to extreme prematurity, not retinopathy of prematurity.
- Early corneal shape differences may persist into childhood.
Purpose:
To compare corneal aberrations in former preterm infants to that of full-term infants.
Methods:
A prospective cross-sectional study was carried out measuring the corneal shape with Scheimpflug imaging in former preterm infants of gestational age (GA) ≤32 weeks and full-term infants with GA ≥37 weeks now being aged between 4 to 10 years. The main outcome measures were corneal aberrations including astigmatism (Zernike: Z2-2; Z22), coma (Z3-1; Z31), trefoil (Z3-3; Z33), spherical aberration (Z40) and root-mean square of higher-order aberrations (RMS HOA). Multivariable analysis was performed to assess independent associations of gestational age groups and of retinopathy of prematurity (ROP) occurrence with corneal aberrations adjusting for sex and age at examination.
Results:
A total of 259 former full-term and 226 preterm infants with a mean age of 7.2 ± 2.0 years were included in this study. Statistical analysis revealed an association of extreme prematurity (GA ≤28 weeks) with higher-order and lower-order aberrations of the total cornea. Vertical coma was higher in extreme prematurity (P < 0.001), due to the shape of the anterior corneal surface, while there was no association with trefoil and spherical aberration. ROP was not associated with higher-order aberrations when adjusted for gestational age group.
Conclusions:
This study demonstrated that specific corneal aberrations were associated with extreme prematurity rather than with ROP occurrence.
