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Retinopathy of Prematurity and Neurodevelopmental and Quality-of-Life Outcomes at 10 Years of Age
Sudhir Sriram1, Elizabeth T Jensen2, Michael E Msall3
1Section of Neonatology, Department of Pediatrics, The University of Chicago, Chicago, Illinois.
Insights
Severe retinopathy of prematurity (ROP) in extremely preterm infants is linked to poorer vision, neurodevelopmental issues, and reduced quality of life by age 10. Blindness from ROP further exacerbates these adverse outcomes.
Area of Science:
- Neonatal ophthalmology
- Developmental pediatrics
- Public health
Background:
- Retinopathy of prematurity (ROP) is a significant concern in extremely preterm infants.
- The long-term impact of ROP severity on neurodevelopment and quality of life requires further investigation.
Purpose of the Study:
- To assess the association between ROP severity and vision, neurodevelopmental outcomes, and quality of life in extremely preterm children at 10 years of age.
- To evaluate the impact of blindness resulting from ROP on these outcomes.
Main Methods:
- Longitudinal cohort study of infants born before 28 weeks gestation (2002-2004).
- ROP severity classified by ophthalmologists during initial hospitalization.
- Neurodevelopmental, behavioral, and quality of life assessments conducted at 10 years of age.
Main Results:
- Increased ROP severity correlated with worse vision, lower math achievement, higher anxiety, and reduced parent-reported quality of life.
- Blindness in one or both eyes was associated with poorer cognitive function, reading ability, and social responsiveness.
Conclusions:
- Severe ROP in extremely preterm infants is linked to adverse neurodevelopmental outcomes and diminished quality of life.
- Blindness following ROP has widespread negative consequences for long-term development.
Abstract:
To evaluate, in a cohort of children born extremely preterm, the hypothesis that increasing severity of retinopathy of prematurity (ROP) is associated with less optimal vision, neurodevelopmental outcomes, and parent-reported quality of life.The Extremely Low Gestational Age Newborn study is a multicenter, longitudinal cohort study. Study participants were born before 28 completed weeks of gestation during the years 2002 to 2004 and were enrolled at birth at 14 U.S. hospitals. Based on retinal examinations by ophthalmologists, participants were classified during their initial hospitalization according to the severity of ROP. At 10 years of age, study psychologists evaluated participants' cognitive abilities, academic achievement, and behaviors indicative of autism spectrum disorder. Participants were classified with regard to gross motor function, anxiety, depression, and quality of life based on parents' responses on standardized questionnaires.After adjustment for confounders, increased severity of ROP was associated with increased severity of vision/eye problems, worse scores on math achievement tests, as well as higher prevalence of anxiety and lower quality of life as reported by the parent when the child was 10 years old. A history of blindness in one or both eyes was associated with these same outcomes, as well as worse scores on assessments of cognitive function, reading ability, and social responsiveness.Among extremely preterm children, severe ROP and severe eye or vision problems are associated with adverse neurodevelopmental outcomes and lower quality of life. · Severe retinopathy of prematurity in extremely low gestational age neonates (ELGANs) is likely to have adverse outcomes at 10 years of age.. · Severe ROP in ELGANs is associated with parent-reported lower quality of life at 10 years.. · Blindness in one or both eyes following ROP is associated with multiple adverse outcomes at 10 years..
