Ocular alignment and refraction in preterm children at 1 and 6 years old

Abstract

PurposeTo investigate cycloplegic refraction and ocular alignment in a population of preterm children at 1 and 6 years old.Patients and methodsWe included 261 preterm infants with a birth weight ≤1,500 g and a gestational age ≤32 weeks; there were 217 preterm infants (group 1), 28 preterm infants with mild retinopathy of prematurity (ROP) (group 2), and 16 preterm infants affected by severe ROP (group 3). Each patient underwent retinoscopy, ocular alignment assessment, and fundus examination at 1 and 6 years old.ResultsThe prevalence of refractive errors and ocular alignment abnormalities at 1 year old in groups 2 and 3 compared to group 1 were, respectively (P<0.05): myopia 18% and 40.6% versus 6.9%; hyperopia 28.6% and 22% versus 39.2%; astigmatism 53.4% and 37.4% versus 53.9%; and strabismus 12.5% and 38% versus 5.3%. At 6 years old, they were, respectively (P<0.05): myopia 10.8% and 28.4% versus 7.4%; hyperopia 48.3% and 40.5% versus 62%; astigmatism 40.9% and 31.1% versus 30.6%; and strabismus 25% and 56.25% versus 11.5%.ConclusionAt 6 years old, we observed increased rates of both hyperopia and strabismus in all groups compared to 1-year-old children. In preterm children with mild and severe ROP, we recorded increased rates of myopia and strabismus versus preterm children without ROP, and the risk of developing these disorders increased significantly with ROP severity. Astigmatism at 1 year old is not predictive of further development during growth. Patients born prematurely should be informed of the possible risks of ocular alterations due to refractive and ocular component changes.

Bilateral myopic strabismus fixus with fat prolapse treated by silicone band loop myopexy and excision of fat

“…However, MSF can manifest in two forms: esotropia-hypotropia complex and exotropia-hypotropia complex. 1 This patient exhibited an esotropia-hypotropia complex form of MSF. In such patients, there is a supero-temporal dislocation of the posterior portion of the elongated globe from the muscle cone due to increased axial length.…”

“…However, MSF can manifest in two forms: esotropia–hypotropia complex and exotropia-hypotropia complex. 1 …”

Comparison of Refractive Measures of Term and Preterm Children Aged One Year Old

“…The first is physiological myopia due to premature birth and gestational stage, the second is myopia due to disruption in the development of the anterior segment, regardless of the development of PR, characterized by narrow anterior chamber angle, increased corneal curvature and spherical lens, and the third type is myopia that can range from mild to severe due to severe PR. [12] Studies have reported that although PR is not present in preterm cases, emmetropization is affected depending on gestational age and birth weight. In preterm cases, it was observed that as the gestational week decreased, myopic values increased and SE values decreased considerably.…”

“…In the study where Muna et al classified preterm cases as no PR, mild PR but not requiring treatment and requiring treatment, in their first age measurements, 3D and below hyperopia values were reported as 39.2%, 28.6% and 22%, respectively, while Akdoğan et al [5] reported that 2D and higher hypermetropia was 56.3% in preterms born below 36 weeks. [12] According to the studies conducted,it is showed that hyperopia values decreased in the preschool period. In the study conducted by Özdemir et al, [11] the incidence of hyperopia in premature children aged 5−7 years without ROP was reported as 21%.…”

Management of strabismus in myopes

“…Specific conditions such as prematurity and associated retinopathy may predispose to strabismus in the presence of myopia. 9 …”