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Published on: July 9, 2016
Tracking visual outcomes - Follow-up on patients born preterm with childhood-onset visual impairment
Hajer A Al-Abaiji1, Kamilla Rothe Nissen1, Carina Slidsborg1
1Department of Ophthalmology, Copenhagen University Hospital - Rigshospitalet, Copenhagen, Denmark.
Insights
Retinopathy of prematurity and cerebral visual impairment are leading causes of visual impairment in preterm children. Combined impairments significantly lower health-related quality of life (HRQoL) compared to isolated visual impairment.
Area of Science:
- Ophthalmology
- Pediatrics
- Public Health
Background:
- Preterm birth is a significant risk factor for ocular complications.
- Childhood-onset visual impairment (VI) in preterm populations requires comprehensive evaluation.
- Health-related quality of life (HRQoL) is a crucial outcome measure in pediatric chronic conditions.
Purpose of the Study:
- To determine the primary causes of VI in preterm-born individuals with childhood-onset VI.
- To assess the association between HRQoL and factors such as age, VI cause, severity, and co-occurring impairments.
- To provide insights for improving long-term outcomes in this vulnerable population.
Main Methods:
- A cohort of preterm patients with VI, identified through the National Danish Registry of Children with Visual Impairment (NDRCVI), was studied.
- Participants underwent comprehensive ophthalmological examinations including visual acuity, refraction, visual fields, and imaging.
- Data on VI severity, HRQoL (using HUI3 score), and etiological factors were collected and analyzed.
Main Results:
- Retinopathy of prematurity (ROP) was the most frequent cause of VI (47%), followed by cerebral visual impairment (CVI) (25%).
- A significant negative correlation was observed between increasing age at assessment and HRQoL.
- Patients with VI combined with other impairments reported significantly lower HRQoL than those with isolated VI.
Conclusions:
- ROP and CVI are the predominant causes of VI in preterm-born children.
- The presence of additional impairments alongside VI substantially diminishes HRQoL.
- Interventions aimed at reducing cerebral damage in preterm infants may improve both visual function and overall quality of life.
Purpose:
Preterm birth is associated with a risk of ocular complications. The primary aim of the study was to evaluate the main cause of visual impairment (VI) in a cohort of preterm born patients who had childhood-onset VI. The association between health-related quality of life (HRQoL) and age, cause-and severity of VI and impairment type was assessed.
Methods:
In Denmark, patients <18 years with VI are enrolled at the National Danish Registry of Children with Visual Impairment (NDRCVI). Patients born preterm and enrolled at NDRCVI at any time between 1988 and 2020 were invited for a follow-up regardless of current age. Examinations performed were visual acuity (VA), refraction, Goldmann visual fields, ocular biometry and posterior segment imaging. The three main outcomes were VA sorted by VI severity (mild, moderate, severe and blind), a score for HRQoL (HUI3) and the main cause of VI.
Results:
Thirty-two preterm-born patients participated in the study with a median age of 28 years at examination (range 8-43). ROP was the main cause of VI in 15 patients (47%) followed by CVI in eight patients (25%). Increasing age at assessment had a significantly negative impact on the HRQoL-score, when unadjusted for type of impairments. HRQoL was significantly lower in patients with combined impairments compared to isolated VI (p = 0.003).
Conclusion:
ROP and CVI were the most common causes of VI. The HRQoL was significantly lower when VI was combined with other impairments in contrast to isolated VI. Reducing cerebral damage in preterm born children is likely to enhance both HRQoL and visual function.
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