Development of grating acuity, letter acuity, and visual fields in small-for-gestational-age preterm infants

Area of Science:

• Developmental Pediatrics
• Ophthalmology
• Neonatology

Background:

• Preterm birth is associated with various developmental challenges.
• Small-for-gestational-age (SGA) infants may face additional risks compared to appropriate-for-gestational-age (AGA) peers.
• Longitudinal visual development in preterm SGA infants requires further investigation.

Purpose of the Study:

• To longitudinally assess visual acuity and visual field development in preterm infants born small-for-gestational-age (SGA) compared to appropriate-for-gestational-age (AGA) infants.
• To identify potential risks associated with being SGA for visual development in the first four years of life.

Main Methods:

• Longitudinal study comparing 21 preterm SGA and 51 preterm AGA children.
• Visual acuity assessed using Teller acuity cards (grating acuity) and HOTV test (recognition acuity).
• Visual fields measured using kinetic perimetry.

Main Results:

• No significant differences found in grating acuity or binocular visual field size between SGA and AGA groups up to 48 months corrected age.
• Good agreement observed in grating acuity and visual field size between matched SGA-AGA pairs.
• Fewer SGA children could complete recognition acuity testing, and those who did showed poorer performance compared to AGA children.

Conclusions:

• Being small-for-gestational-age (SGA) does not appear to increase risk for grating acuity or visual field deficits in preterm children up to age 4.
• Preterm SGA children may be at risk for deficits in recognition acuity, particularly with complex targets and increased testing distances.
• Early visual screening for preterm infants should consider different acuity measures to detect potential deficits in SGA populations.