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Effects of retinopathy of prematurity and preterm birth on childhood visual outcomes
Myra Leung1, Joanna Black1, Tina Y Gao1
1School of Optometry and Vision Science, University of Auckland, Auckland, New Zealand.
Insights
Children born preterm, with or without retinopathy of prematurity (ROP), show similar late-childhood visual outcomes to full-term peers. However, preterm children may experience reduced visuomotor integration, highlighting the need for further research into long-term ocular effects.
Area of Science:
- Ophthalmology
- Pediatrics
- Developmental Biology
Background:
- Late-childhood visual outcomes in preterm infants, with or without retinopathy of prematurity (ROP), are not well understood.
- This knowledge gap limits opportunities for preventative and early interventions for visual impairments.
Purpose of the Study:
- To investigate the impact of ROP and preterm birth on visual outcomes in late childhood.
- To compare visual function and ocular structures between children with a history of ROP, preterm birth without ROP, and full-term birth.
Main Methods:
- An observational study assessed children aged 8-10 years corrected age.
- Participants included those born preterm (<30 weeks GA or <1250g) screened for ROP, preterm without ROP, and full-term infants.
- Visual outcomes, including visual acuity, strabismus, stereoacuity, spectacle use, axial length, corneal curvature, retinal thickness, and visuomotor integration, were compared using generalized linear regression models.
Main Results:
- No significant differences in favorable overall visual outcomes were found between the ROP, preterm without ROP, and term groups (p=0.43).
- Children with ROP exhibited shorter axial length and steeper corneal curvature compared to the term group (p<0.01).
- Both preterm groups had thicker central retinas, and the term group showed better visuomotor integration than the ROP group (p=0.01).
Conclusions:
- Children with mild ROP and those born preterm without ROP have comparable late-childhood visual outcomes to full-term peers.
- Preterm children, particularly those with ROP, are at risk for reduced visuomotor integration and ocular structural changes.
- Further research is needed to fully understand the long-term implications of preterm birth and ROP on visual development.
Clinical Relevance:
Late-childhood visual outcomes in children born preterm, with or without retinopathy of prematurity (ROP), are not well understood, limiting the opportunities for preventative and early interventions.
Background:
This observational study investigated how ROP and preterm birth may affect late-childhood visual outcomes.
Methods:
Children born at gestational age <30 weeks or birth weight <1250 grams and screened for ROP, and at full-term (gestational age ≥ 37 weeks) were assessed at 8-10 years corrected age. The primary outcome, favourable overall visual outcome (good presenting vision in the better eye [≤0.30 logMAR], no strabismus, passing stereoacuity, not requiring spectacles), and other outcomes were compared using generalised linear regression models.
Results:
The study included 111 children (ROP n = 47 [stages: 1 = 23, 2 = 19, 3 = 4, 4 or worse = 1; 3 laser photocoagulation treatment]; preterm birth and no ROP n = 17; and term n = 37), aged 8.9 (interquartile range 8.6, 9.4) years. There were no significant differences in favourable overall visual outcome (composite measure) between the groups (ROP, 21/44 (48%); preterm birth and no ROP, 8/14 (57%); term, 20/32 (63%); p = 0.43). Children with ROP had shorter axial length (p = 0.01) and steeper corneal curvature (p = 0.001) than the term group; both preterm groups had thicker central retinas than the term group (p < 0.0001). The term group had better visuomotor integration scores than the ROP group (p = 0.01). No group differences in global motion or electrophysiology were observed.
Conclusion:
In this small observational cohort, children with mainly mild ROP had similar visual outcomes to children born preterm without ROP and at full-term but remain at risk of reduced visuomotor integration in late childhood. Children born preterm are at risk of ocular structural changes, but further investigation is required to understand the long-term implications.
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