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Refractive state and visual acuity of children with extremely low birth weight at 3 years old in Japan
Takako Tachikawa1, Ritsuko Ueno2, Tetsuko Mita2
1Department of Ophthalmology, Tokyo Metropolitan Ohtsuka Hospital, Minami-Ohtsuka 2-8-1, Toshima-ku, Tokyo, Japan. takako_tachikawa@tmhp.jp.
Insights
Extremely low birth weight (ELBW) children without or with early retinopathy of prematurity (ROP) show normal visual acuity and refractive status. More severe ROP requiring treatment is linked to poorer outcomes.
Area of Science:
- Ophthalmology
- Neonatology
- Pediatrics
Background:
- Extremely low birth weight (ELBW) infants are at high risk for visual impairments.
- Retinopathy of prematurity (ROP) is a significant concern in ELBW infants, potentially leading to long-term vision problems.
Purpose of the Study:
- To assess the refractive status and visual acuity in 3-year-old children who were born with extremely low birth weight (ELBW).
- To categorize visual outcomes based on the severity of retinopathy of prematurity (ROP) and its treatment.
Main Methods:
- A retrospective cohort study involving 161 ELBW children born between 2009 and 2014.
- Children were grouped based on ROP status: no ROP, reverse ROP, photocoagulation (PC) zone II (ZII), PC zone I (ZI), and PC (ZI) with lens-sparing vitrectomy (vit).
- Evaluation included best-corrected visual acuity (BCVA) and spherical equivalence (SE) at age 3 years.
Main Results:
- The majority of ELBW children (79.5%) fell into the no ROP, reverse ROP, and PC (ZII) groups, showing no significant differences in SE or BCVA.
- Children in the PC (ZI) and PC (ZI + vit) groups exhibited significantly worse SE and BCVA compared to the other groups.
- A significant negative correlation was found between SE and BCVA (r = -0.43, p < 0.0001), indicating poorer vision with more myopic refractive errors.
Conclusions:
- ELBW children without significant ROP or those with milder forms (reverse ROP, PC ZII) generally have favorable visual outcomes.
- Advanced ROP requiring laser treatment or vitrectomy is associated with substantial refractive errors and reduced visual acuity.
- Refractive status is a key indicator correlating with visual acuity in ELBW children.
Purpose:
To investigate the refractive status and visual acuity of 3-year-old children with extremely low birth weight (ELBW).
Study Design:
Retrospective cohort study.
Methods:
We examined 161 children born between January 2009 and December 2014. The children were divided into five groups for evaluation of visual acuity and refraction: no retinopathy of prematurity (ROP), reverse ROP, photocoagulation (PC) zone II (ZII), PC (ZI), and PC (ZI + lens-sparing vitrectomy [vit]).
Results:
Median (1st quartile, 3rd quartile) gestational age was 25 (24, 26) weeks. Median birth weight was 738 (588, 846) g. Spherical equivalence (SE) was +0.38 (-0.06, +0.75) diopters (D) in no ROP, +0.63 (-0.25, +1.34) D in reverse ROP, +0.38 (-0.75, +1.31) D in PC (ZII), -3.31 (-8.06, +0.16) D in PC (ZI), and -12.00 (-13.50, -4.50) D in PC (ZI+ vit) children. Best corrected visual acuity (BCVA) in log MAR was 0.15 (0.07, 0.26) in no ROP, 0.17 (0.10, 0.30) in reverse ROP, 0.22 (0.10, 0.38) in PC (ZII), 0.45 (0.22, 0.55) in PC (ZI), and 1.10 (0.82, 1.30) in PC (ZI+ vit) children. There was a significant correlation between SE and BCVA (r = -0.43, p < 0.0001).
Conclusion:
The no ROP, reverse ROP, and PC (ZII) groups showed no significant differences in SE or BCVA, accounting for 79.5% of ELBW children. SE and BCVA in the PC (ZI) and PC (ZI+ vit) groups were worse than in the other groups. The current results reveal a correlation between SE and BCVA.
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