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Children with blindness due to retinopathy of prematurity: a population-based study. Perinatal data, neurological and
L Jacobson1, E Fernell, U Broberger
1Department of Ophthalmology, Huddinge University Hospital, Sweden.
Insights
Retinopathy of prematurity (ROP) caused total blindness in 27 Swedish children born 1980-1990. Despite extensive eye surgery, most had severe neurological impairments and delayed development.
Area of Science:
- Ophthalmology
- Pediatrics
- Neonatology
Background:
- Retinopathy of prematurity (ROP) is a leading cause of childhood blindness.
- Premature infants, especially those with complicated perinatal periods, are at high risk for ROP.
- Late diagnosis and advanced retinal detachment often complicate ROP cases.
Purpose of the Study:
- To investigate the long-term outcomes of total blindness due to ROP in a Swedish cohort.
- To assess the impact of ROP on neurodevelopmental status and habilitation.
- To evaluate the effectiveness of ophthalmological interventions in ROP-related blindness.
Main Methods:
- Population-based study of 27 children with total blindness from ROP, born 1980-1990 in Sweden.
- Review of national registers for visually impaired children.
- Assessment of gestational age, perinatal history, ophthalmological interventions, and neurodevelopmental outcomes.
Main Results:
- All children had a gestational age < 31 weeks; most had complicated perinatal histories.
- Late diagnosis led to advanced bilateral retinal detachment in most cases.
- Three-quarters of the children exhibited major neurological impairments (e.g., cerebral palsy, epilepsy).
- Extensive ophthalmological efforts did not improve visual function post-surgery.
- Ophthalmological interventions appeared to delay neurodevelopmental assessments and habilitation.
Conclusions:
- Total blindness from ROP in this cohort was associated with significant prematurity and perinatal complications.
- Aggressive ophthalmological management did not restore vision and may have hindered developmental support.
- Early detection and comprehensive, multidisciplinary care are crucial for optimizing outcomes in ROP-related blindness.
Abstract:
A population-based group of 27 children with total blindness due to retinopathy of prematurity (ROP), born in Sweden from 1980 to 1990, was examined. They constituted all but two of the total of 29 children with total blindness due to ROP known to the national register of visually impaired children when reviewed from 1980 to 1 January 1995. All children had a gestational age of less than 31 weeks and most had had a complicated perinatal period. The retinal disease was discovered late, most often after it had already progressed to bilateral retinal detachment. Repeated vitreoretinal surgery had been performed in most children, but postoperative visual function did not improve. Three-quarters of the group had major neurological impairment (mental retardation, cerebral palsy, or epilepsy) at age 4 to 14 years. There was an impression that extensive ophthalmological efforts delayed neurodevelopmental assessments and examinations as well as adequate habilitation.
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