Related Experiment Videos
Ocular morbidity in infants of very low birth weight
Insights
Ophthalmic screening of very low birth weight infants revealed significant ocular issues like squint and refractive errors. Fortunately, severe retrolental fibroplasia (RLF) blindness has not increased despite higher survival rates.
Area of Science:
- Ophthalmology
- Neonatology
- Pediatrics
Background:
- Infants weighing less than 1500g face significant risks for ocular complications.
- Improved survival rates for very low birth weight (VLBW) infants necessitate understanding their long-term visual health.
- Retrolental fibroplasia (RLF) was a major cause of blindness in premature infants, but its prevalence may be changing.
Purpose of the Study:
- To assess the prevalence of ocular lesions in surviving VLBW infants.
- To determine if increased VLBW infant survival has led to a rise in severe RLF or other visual impairments.
- To identify specific visual conditions requiring follow-up screening in this population.
Main Methods:
- Retrospective analysis of ophthalmic examinations for 111 VLBW infants (born 1977-8).
- Infants were born at or transferred to the Royal Women's Hospital, Melbourne.
- Data collected on birth weight, survival, and presence of ocular lesions including RLF, refractive errors, and squint.
Main Results:
- 33% of examined VLBW infants had significant ocular lesions.
- Common findings included squint (19%), significant refractive error (17%), and cicatricial RLF (10%).
- No cases of blindness due to RLF were observed, and myopia was associated with neonatal RLF changes.
Conclusions:
- Increased VLBW infant survival has not resulted in a higher prevalence of severe RLF-related blindness.
- VLBW infants require ongoing ophthalmic screening for refractive errors and squint.
- Screening for RLF in the neonatal period and for other visual issues at age 2 is recommended.
Abstract:
In the years 1977-8,258 infants weighing less than 1500 g were born at, or transferred to, the Royal Women's Hospital, Melbourne; 177 (68.5%) survived, and 111 of these attended for an ophthalmic examination. Significant ocular lesions were found in 37 (33%): 21 (19%) children had squint, 19 (17%) had a significant refractive error, 11 (10%) had cicatricial retrolental fibroplasia (RLF), and 3 (2.7%) had very poor vision due to optic atrophy associated with cerebral palsy. No children were blind owing to RLF, indicating that the recent increase in survival rate of infants of very low birth weight has not been accompanied by an increase in the prevalence of severe RLF. In those children with neither cerebral palsy nor RLF the prevalence of squint was 11% and of refractive errors 13%. Myopia was found mainly in children who had shown RLF changes in the neonatal period. It is recommended that infants of very low birth weight continue to be screened in the premature nursery for RLF, and also at the age of 2, for the detection of refractive errors and squint.