Suboptimal visual acuity and neurodevelopment at five years in children born very preterm: the EPIPAGE-2 cohort study

Area of Science:

• Pediatric Ophthalmology
• Developmental Neuroscience
• Public Health

Background:

• Preterm infants often exhibit visual impairments beyond retinopathy of prematurity.
• Suboptimal visual acuity (VA) is defined as binocular VA between 5-6.3/10 and 8/10.
• The relationship between suboptimal VA and neurodevelopment in preterm children requires further investigation.

Purpose of the Study:

• To examine the association between suboptimal visual acuity and neurodevelopmental outcomes in children born preterm.
• To identify specific neurodevelopmental deficits associated with varying degrees of suboptimal VA.

Main Methods:

• Secondary analysis of the French EPIPAGE-2 cohort (24+0 to 31+6 weeks gestation).
• Children assessed at 5.5 years, categorized into VA groups: 5-6.3/10, 8/10, and 10/10 (reference).
• Neurodevelopment assessed using Wechsler scales (IQ), MABC-2 (motor skills), and SDQ (behavioral difficulties), with adjustments for confounding factors.

Main Results:

• 62% of preterm children exhibited suboptimal VA.
• Suboptimal VA was associated with significantly lower full-scale IQ scores.
• Children with suboptimal VA showed poorer motor skills (MABC-2) and increased behavioral difficulties (SDQ).

Conclusions:

• Suboptimal visual acuity is prevalent in preterm children and indicates a higher risk of neurodevelopmental challenges.
• Comprehensive neurodevelopmental and neurovisual evaluations are recommended for preterm infants with suboptimal VA.
• Findings highlight the importance of early screening and intervention for visual and neurological deficits in this population.