Ophthalmological follow-up of prematurely born children in preschool age: prospective study of visual acuity, refractive errors and strabismus

Abstract

Background. Preterm birth is a very relevant problem. Retinopathy of prematurity in its severe forms causes visual impairment or can lead to blindness. The aim of the present study was to describe the visual outcome in prematurely born and full-term children at the preschool age and to evaluate the effects of prematurity per se, ROP, and treatment on visual acuity and refractive errors.Materials and methods. A prospective study on the incidence of ROP during 2006-2008 included 103 preterm infants. 81 had ROP and 22 had no history of ROP; 40 were age-matched healthy children. All underwent a complete ophthalmic examination.Results. Significant myopia (≤ -0.50D) in prematurely born children differed from full-term ones. The ROP treated group had the highest prevalence of myopia (P < 0.001). Astigmatism (>2D) was dominant in the premature group (39%) as compared with the control group (0%) (P < 0.05). 65% had significant anisometropia and 35% had high anisometropia in the preterm group and only 5% had significant anisometropia in the full-term group (P = 0.014). Within the preterm group, the ROP treated children had the highest frequency of anisometropia and strabismus (P = 0.001). Visual acuity was significantly better in the full-term than in prematurely born children (P < 0.001). Three children (7.7%) of the premature ROP treated group were visually impaired.Conclusions. Refractive errors, astigmatism, anisometropia and strabismus were more common in prematurely born children than in those born at term, especially the ROP treated group. ROP outcome and prematurity per se remain risk factors for visual impairment to prematurely born children at preschool age.