Br J Ophthalmol 1999;83:143-150 ( February )
Ophthalmological follow up of preterm infants: a population
based, prospective study of visual acuity and strabismus
G Holmström,a b
M el Azazi,b c
U Kugelbergc
a Department of
Ophthalmology, Huddinge University Hospital, Karolinska Institute,
Stockholm, Sweden, b Department of Ophthalmology, Danderyd Hospital,
Stockholm, Sweden, c Department of Ophthalmology, St Erik's Eye
Hospital, Stockholm, Sweden
Correspondence to: G Holmström, MD, Department of
Ophthalmology, Academic Hospital, University of Uppsala, S 751 85 Uppsala, Sweden.
Accepted for publication 30 July 1998
BACKGROUND/AIMS Prematurely
born infants are known to have an increased rate of ophthalmological
morbidity. The aim of the present study was to investigate visual
acuity and ocular alignment in a population of preterm infants in a
geographical area, in infants with and without retinopathy of
prematurity (ROP).
METHODSA prospective
population based study of ophthalmological status of preterm infants
with a birth weight of 1500 g or less was performed during 3.5 years,
with examinations at 6, 18, 30, and 42 months of corrected age. Visual
acuity was tested using linear optotypes. Multiple regression analyses
were used to analyse independent risk factors for poor vision and strabismus.
RESULTSPoor
vision (<0.3) was detected in 2.5% (6/237) of the children. Of these,
only two (0.8%) had a severe visual impairment (<0.1). Strabismus
occurred in 13.5% (31/229). Children with cryotreated ROP and
neurological complications ran the highest risk of poor vision and
strabismus, according to multiple regression analysis. Among children
without a history of ROP or neurological
complications, 34% had a visual acuity <0.7 and 5.9% had
strabismus, compared with 61% and 22%, respectively, among the
children with ROP or neurological complications.
CONCLUSIONSThe
overall incidence of subnormal vision and strabismus in children born
prematurely was higher than in a full term population of the same age.
On the basis of this study, follow up of all preterm infants screened
for ROP is recommended and general guidelines are suggested.
Keywords:
prematurity;
prospective study;
retinopathy of prematurity;
visual outcome;
strabismus
© 1999 by British Journal of Ophthalmology
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