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Impaired cognitive ability at 2.5 years predicts later visual and ophthalmological problems in children born very

Jonina Hreinsdottir1, Ylva Fredriksson Kaul2, Lena Hellström-Westas2

  • 1Department of Neuroscience, Ophthalmology, Uppsala University, Uppsala, Sweden.

Acta Paediatrica (Oslo, Norway : 1992)
|December 31, 2017
PubMed

Insights

Very preterm infants often experience visual problems, including subnormal visual acuity and strabismus, by age 6.5 years. Retinopathy of prematurity and early brain injury are key predictors of these visual impairments.

Area of Science:

  • Ophthalmology
  • Neonatology
  • Developmental Pediatrics

Background:

  • Children born very preterm (<32 weeks gestation) are at increased risk for visual impairments.
  • Early identification of predictive factors is crucial for timely intervention and improved outcomes.

Purpose of the Study:

  • To identify predictive factors for visual problems at 6.5 years in children born very preterm.
  • To compare ophthalmological outcomes between very preterm children and a full-term reference group.

Main Methods:

  • Prospective cohort study of very preterm infants (n=84) and full-term controls (n=64) in Uppsala County, Sweden (2004-2007).
  • Neonatal screening for retinopathy of prematurity (ROP), visual tracking at 4 months, cognitive/visuospatial tests at 2.5 years, and ophthalmological testing at 6.5 years.
  • Statistical analysis to identify predictors of visual problems.

Main Results:

  • Subnormal visual acuity (≤0.8) was more common in preterm children (31% vs 14%).
  • Preterm children had higher rates of impaired contrast sensitivity (36% vs 19%) and strabismus (8% vs 0%).
  • Low gestational age, ROP, severe brain injury (intraventricular hemorrhage/periventricular leukomalacia), and cognitive disability at 2.5 years predicted visual problems at 6.5 years.

Conclusions:

  • Children born very preterm exhibit a higher prevalence of ophthalmological issues, including subtle visual dysfunctions, at 6.5 years.
  • ROP, early brain injury, and impaired cognitive function are significant predictors of later visual problems.
  • Visual tracking at 4 months was not a reliable predictor of ophthalmological outcomes at 6.5 years.
Abstract

Keywords:
CognitionLong termRisk factorVery pretermVisual outcome

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