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Visual function in Norwegian children aged 5-13 years with prenatal exposure to opioid maintenance therapy: A
Anne Kathinka Aslaksen1,2,3, Gro Horgen Vikesdal4, Marit Torbergsen Voie5
1Department of Paediatrics, Sørlandet Hospital, Arendal, Norway.
Insights
Children exposed to opioid maintenance therapy (OMT) in utero showed poorer visual acuity, increased strabismus, and nystagmus. Buprenorphine exposure was linked to better visual outcomes than methadone.
Area of Science:
- Ophthalmology
- Developmental Pediatrics
- Pharmacology
Background:
- Prenatal exposure to opioid maintenance therapy (OMT) can impact child development.
- Understanding the long-term visual effects of OMT is crucial for pediatric care.
Purpose of the Study:
- To evaluate visual function in school-aged children exposed prenatally to OMT.
- To compare visual outcomes between prenatal methadone and buprenorphine exposure.
Main Methods:
- Cross-sectional case-control study comparing 63 OMT-exposed children (5-13 years) with 63 controls.
- Assessed visual acuity, orthoptic status, refractive state, color vision, and visual field.
- Analyzed differences between methadone and buprenorphine exposure groups.
Main Results:
- OMT-exposed children had significantly poorer visual acuity, higher rates of strabismus (30% vs 4.8%), and nystagmus (16% vs 1.6%).
- Reduced accommodative amplitude was observed in the OMT group.
- Methadone exposure was associated with worse visual acuity, more strabismus, nystagmus, hypermetropia, and astigmatism compared to buprenorphine.
Conclusions:
- Prenatal exposure to methadone or buprenorphine is associated with increased prevalence of strabismus and nystagmus, and reduced visual acuity and accommodation.
- Buprenorphine appears to be associated with more favorable visual outcomes than methadone in OMT.
Purpose:
To assess various aspects of visual function in school children prenatally exposed to opioid maintenance therapy (OMT) and to explore possible outcome differences between prenatal methadone and buprenorphine exposure.
Methods:
In a cross-sectional case-control study, 63 children aged 5-13 years with prenatal OMT exposure were compared with 63 age- and gender-matched, non-exposed controls regarding important visual parameters, such as visual acuity, orthoptic status, refractive state, colour vision, and visual field.
Results:
The OMT-exposed children had significantly poorer visual acuity, both for the best eye, the worst eye and binocularly. Two children had mild visual impairment. Manifest strabismus was more frequent in the OMT group, 30%, vs. 4.8% in the control group. The most frequent types of strabismus were accommodative esotropia and intermittent exotropia. Manifest nystagmus was present in 10 (16%) of the exposed children compared to one among the non-exposed children. The accommodative amplitude was decreased in the OMT group compared to the controls. After adjusting for polydrug exposure and SGA (small-for-gestational-age), the between-group differences in visual acuity, strabismus, and nystagmus remained. The methadone-exposed children had poorer visual acuity, increased frequency of strabismus and a higher percentage of nystagmus, hypermetropia and astigmatism compared to the buprenorphine-exposed children.
Conclusions:
School-age children exposed to methadone or buprenorphine in utero had a higher prevalence of strabismus and nystagmus, and a lower visual acuity and accommodation amplitude. Buprenorphine exposure was associated with more favourable results than methadone exposure on most visual outcome measures and should be the preferred substance in OMT.
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