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Ophthalmologic Outcome at 30 Months' Corrected Age of a Prospective Swedish Cohort of Children Born Before 27 Weeks of Gestation The Extremely Preterm Infants in Sweden Study

Holmstrom, Gerd E.; Källén, Karin LU ; Hellstrom, Ann; Jakobsson, Peter G.; Serenius, Fredrik; Stjernqvist, Karin LU and Tornqvist, Kristina LU (2014) In JAMA Ophthalmology 132(2). p.182-189
Abstract
IMPORTANCE Follow-up at 30 months' corrected age reveals eye and visual problems in one-third of children born extremely prematurely (<27 weeks' gestation). OBJECTIVE To investigate the ophthalmologic outcome of extremely preterm children at 30 months' corrected age. DESIGN, SETTING, AND PARTICIPANTS A prospective, population-based follow-up study (Extremely Preterm Infants in Sweden Study [EXPRESS]) was conducted in Sweden. The population included extremely preterm infants (<27 weeks' gestation) born in Sweden between 2004 and 2007, of whom 491 survived until age 2.5 years. Screening for retinopathy of prematurity (ROP) was performed in the neonatal period. At 30 months' corrected age, an ophthalmologic assessment was performed in... (More)
IMPORTANCE Follow-up at 30 months' corrected age reveals eye and visual problems in one-third of children born extremely prematurely (<27 weeks' gestation). OBJECTIVE To investigate the ophthalmologic outcome of extremely preterm children at 30 months' corrected age. DESIGN, SETTING, AND PARTICIPANTS A prospective, population-based follow-up study (Extremely Preterm Infants in Sweden Study [EXPRESS]) was conducted in Sweden. The population included extremely preterm infants (<27 weeks' gestation) born in Sweden between 2004 and 2007, of whom 491 survived until age 2.5 years. Screening for retinopathy of prematurity (ROP) was performed in the neonatal period. At 30 months' corrected age, an ophthalmologic assessment was performed in 411 of 491 children (83.7%). MAIN OUTCOMES AND MEASURES Visual acuity, manifest strabismus, and refractive errors were evaluated. RESULTS Visual impairment was identified in 3.1% of the children, and 1.0% were blind. Refractive errors, defined as myopia less than -3 diopters (D), hypermetropia greater than +3 D, astigmatism 2 D or more, and/or anisometropia 2 D or more, were found in 25.6% of the children, and 14.1% had manifest strabismus. There were significant associations between visual impairment and treated ROP (P = .02), cognitive disability (P < .001), and birth weight (P = .02). Multiple regression analyses revealed significant associations between strabismus and treated ROP (P < .001), cognitive disability (P < .01), and cerebral palsy (P = .02). Refractive errors were significantly correlated with severity of ROP (right eye, P < .001; left eye, P < .01). Children who had been treated for ROP had the highest frequency (69.0%) of eye and visual abnormalities. CONCLUSIONS AND RELEVANCE One-third of the extremely prematurely born children in this study had some kind of eye or visual problems, such as visual impairment, strabismus, or major refractive error. Despite being born extremely preterm, the present cohort has a similar prevalence of blindness and visual impairment as in previous Swedish cohorts of children born less prematurely. (Less)
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author
organization
publishing date
type
Contribution to journal
publication status
published
subject
in
JAMA Ophthalmology
volume
132
issue
2
pages
182 - 189
publisher
American Medical Association
external identifiers
  • wos:000331367600010
  • scopus:84894287175
ISSN
2168-6165
DOI
10.1001/jamaophthalmol.2013.5812
language
English
LU publication?
yes
id
b479fb5b-4632-428c-aa26-b5d0d33d8b77 (old id 4368385)
date added to LUP
2014-04-02 09:26:54
date last changed
2017-11-12 03:01:45
@article{b479fb5b-4632-428c-aa26-b5d0d33d8b77,
  abstract     = {IMPORTANCE Follow-up at 30 months' corrected age reveals eye and visual problems in one-third of children born extremely prematurely (&lt;27 weeks' gestation). OBJECTIVE To investigate the ophthalmologic outcome of extremely preterm children at 30 months' corrected age. DESIGN, SETTING, AND PARTICIPANTS A prospective, population-based follow-up study (Extremely Preterm Infants in Sweden Study [EXPRESS]) was conducted in Sweden. The population included extremely preterm infants (&lt;27 weeks' gestation) born in Sweden between 2004 and 2007, of whom 491 survived until age 2.5 years. Screening for retinopathy of prematurity (ROP) was performed in the neonatal period. At 30 months' corrected age, an ophthalmologic assessment was performed in 411 of 491 children (83.7%). MAIN OUTCOMES AND MEASURES Visual acuity, manifest strabismus, and refractive errors were evaluated. RESULTS Visual impairment was identified in 3.1% of the children, and 1.0% were blind. Refractive errors, defined as myopia less than -3 diopters (D), hypermetropia greater than +3 D, astigmatism 2 D or more, and/or anisometropia 2 D or more, were found in 25.6% of the children, and 14.1% had manifest strabismus. There were significant associations between visual impairment and treated ROP (P = .02), cognitive disability (P &lt; .001), and birth weight (P = .02). Multiple regression analyses revealed significant associations between strabismus and treated ROP (P &lt; .001), cognitive disability (P &lt; .01), and cerebral palsy (P = .02). Refractive errors were significantly correlated with severity of ROP (right eye, P &lt; .001; left eye, P &lt; .01). Children who had been treated for ROP had the highest frequency (69.0%) of eye and visual abnormalities. CONCLUSIONS AND RELEVANCE One-third of the extremely prematurely born children in this study had some kind of eye or visual problems, such as visual impairment, strabismus, or major refractive error. Despite being born extremely preterm, the present cohort has a similar prevalence of blindness and visual impairment as in previous Swedish cohorts of children born less prematurely.},
  author       = {Holmstrom, Gerd E. and Källén, Karin and Hellstrom, Ann and Jakobsson, Peter G. and Serenius, Fredrik and Stjernqvist, Karin and Tornqvist, Kristina},
  issn         = {2168-6165},
  language     = {eng},
  number       = {2},
  pages        = {182--189},
  publisher    = {American Medical Association},
  series       = {JAMA Ophthalmology},
  title        = {Ophthalmologic Outcome at 30 Months' Corrected Age of a Prospective Swedish Cohort of Children Born Before 27 Weeks of Gestation The Extremely Preterm Infants in Sweden Study},
  url          = {http://dx.doi.org/10.1001/jamaophthalmol.2013.5812},
  volume       = {132},
  year         = {2014},
}