As-indicated versus routine vision screening of preterm children: a 17-year retrospective regional study

Area of Science:

• Ophthalmology
• Neonatal Care
• Public Health

Background:

• Preterm infants are at higher risk for visual impairments, including retinopathy of prematurity (ROP).
• Effective screening strategies are crucial for early detection and intervention in this vulnerable population.

Purpose of the Study:

• To compare the outcomes of routine, scheduled vision screening versus as-indicated ophthalmological investigations for preterm infants.
• To evaluate the effectiveness of different screening approaches in identifying visual impairments in preterm children.

Main Methods:

• A retrospective study comparing two groups of preterm infants (born <32 weeks gestation or <1500g) in Denmark (1997-2014).
• The 'as-indicated' group (1997-2009) received investigations only if treated for ROP or referred for visual issues.
• The 'screening' group (2010-2014) received scheduled ophthalmological investigations at 6 months and 3 years.

Main Results:

• No significant difference in the proportion of children with visual acuity <6/18 at 3 years between the as-indicated (2.7%) and screening (3.5%) groups (p=0.24).
• Cerebral palsy and epilepsy were significantly associated with vision impairment (p<0.01), but treated ROP was not.
• Refractive errors, particularly astigmatism, were common at 3 years (61%), but not associated with gestational age, birthweight, or ROP history.

Conclusions:

• Scheduled vision screening at 6 months and 3 years for preterm infants did not detect more visually impaired children than an as-indicated approach.
• The findings suggest that current screening protocols for retinopathy of prematurity may be adequate in identifying visual impairments in preterm populations.