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Impaired vision in children prenatally exposed to methadone: an observational cohort study

R Hamilton1, A Mulvihill2, L Butler3

  • 1Royal Hospital for Children, NHS Greater Glasgow & Clyde and the University of Glasgow, Glasgow, G51 4TF, UK. ruth.hamilton@glasgow.ac.uk.

Eye (London, England)
|July 4, 2023
PubMed

Insights

Children exposed to methadone in utero are nearly twice as likely to experience visual impairments by primary school age. Early visual assessments are recommended for infants with prenatal opioid exposure history.

Area of Science:

  • Pediatric Ophthalmology
  • Neonatal Abstinence Syndrome Research
  • Prenatal Substance Exposure Studies

Background:

  • Children born to mothers undergoing methadone maintenance treatment (MMOD) may face developmental challenges.
  • Understanding the long-term effects of in utero substance exposure is crucial for early intervention.

Purpose of the Study:

  • To determine the prevalence of visual assessment failures in children aged 8-10 years born to MMOD mothers.
  • To correlate these visual outcomes with documented in utero substance exposure.

Main Methods:

  • An observational cohort study followed methadone-exposed and comparison children.
  • Visual assessments evaluated acuity, strabismus, nystagmus, and stereovision.
  • Statistical analysis adjusted for confounding variables like maternal tobacco use.

Main Results:

  • Methadone-exposed children showed a significantly higher likelihood of visual 'fail' outcomes (adjusted OR 2.6, aRR 1.8).
  • No significant difference in visual 'fail' rates was observed between methadone-exposed children who received treatment for neonatal abstinence syndrome (NAS/NOWS) and those who did not.
  • Visual assessment failures included reduced acuity, strabismus, nystagmus, and impaired stereovision.

Conclusions:

  • Children exposed to methadone prenatally exhibit a nearly twofold increased risk of significant visual abnormalities by primary school age.
  • Prenatal methadone exposure should be considered in the differential diagnosis of nystagmus.
  • Routine visual screening before school entry is recommended for children with a history of prenatal opioid exposure.
Abstract

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