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Visual acuity, amblyopia and refractive error in preterm children with and without retinopathy of prematurity -

Achim Fieß1, Sandra Gißler1, Alica Hartmann1

  • 1Department of Ophthalmology, University Medical Center of the Johannes Gutenberg University Mainz, Mainz, Germany.

Acta Ophthalmologica
|May 28, 2025
PubMed

Insights

Extreme prematurity (≤28 weeks) and retinopathy of prematurity (ROP) significantly impact visual development in children. ROP treatment further exacerbates these visual outcomes, affecting acuity and increasing amblyopia risk.

Area of Science:

  • Ophthalmology
  • Neonatology
  • Pediatrics

Background:

  • Preterm birth is a leading cause of visual impairment in children.
  • Retinopathy of prematurity (ROP) is a significant complication of preterm birth, potentially leading to severe vision loss.
  • Understanding the long-term visual outcomes in preterm infants is crucial for early intervention and management.

Purpose of the Study:

  • To evaluate visual outcomes in children born preterm, considering gestational age, placental factors, and ROP.
  • To identify key risk factors influencing visual acuity, amblyopia, refractive error, and lens opacities in this population.

Main Methods:

  • Prospective observational cohort study of 949 children (4-17 years old) born preterm and full-term.
  • Assessment of visual acuity, amblyopia, refractive error, and lens opacifications.
  • Logistic regression analysis adjusted for multiple perinatal and maternal factors.

Main Results:

  • Amblyopia prevalence was strongly linked to gestational age ≤28 weeks, placental insufficiency, and ROP treatment.
  • Distant corrected visual acuity correlated with gestational age, birth weight, ROP status/treatment, and perinatal adverse events.
  • ROP treatment was associated with worse spherical equivalent and larger lens opacifications.

Conclusions:

  • Perinatal factors, particularly extreme prematurity (≤28 weeks) and ROP, significantly affect visual development.
  • ROP and its treatment are critical determinants of visual acuity, refractive error, and amblyopia in children born preterm.
  • These findings underscore the importance of vigilant screening and management of ROP in preterm infants.
Abstract

Keywords:
ROPamblyopiaepidemiologypreterm birthrefractive errorvisual acuity

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