Retrospective evaluation of ophthalmological and neurological outcomes for infants born before 24 weeks gestational age in a Swedish cohort
Year: 2022
Type: article
Study design: Observational Study
Abstract: OBJECTIVES: To retrospectively evaluate ophthalmological and neurological outcomes in a Swedish cohort of infants born before 24 weeks gestational age (GA) and explore risk factors for visual impairment. SETTING: Eye and paediatric clinics in Sweden. PARTICIPANTS: Infants screened for retinopathy of prematurity (ROP) (n=399), born before 24 weeks GA, 2007-2018. Cases were excluded if ophthalmological follow-up records could not be traced. PRIMARY AND SECONDARY OUTCOME MEASURES: Primary outcomes were ophthalmological, including visual acuity (VA), refractive error, strabismus, nystagmus and cerebral visual impairment (CVI). Secondary outcomes comprised neonatal and neurological morbidities. Data were retrospectively retrieved from medical records. RESULTS: The 355 assessed children had a median GA of 23 weeks and 2 days and a median birth weight of 565 g. At the last available ophthalmological examination, the median age was 4.8 years (range 0.5-13.2 years). Nystagmus was recorded in 21.1%, strabismus in 34.8%, and 51.0% wore spectacles. Seventy-three of 333 (21.9%) were visually impaired, defined as being referred to a low vision clinic and/or having a VA less than 20/60 at 3.5 years of age or older. ROP treatment was a significant risk factor for visual impairment (OR 2.244, p=0.003). Visually impaired children, compared with children without visual impairment, more often had neurological deficits such as intellectual disability 63.8% versus 33.3% (p<0.001), epilepsy 21.1% versus 7.5% (p=0.001) and autism spectrum disorders 32.8% versus 20.9% (p=0.043). Nine of the 355 children had been diagnosed with CVI. CONCLUSIONS: Children born before 24 weeks GA frequently had visual impairment in association with neurological deficits. CVI was rarely diagnosed. A multidisciplinary approach for the evaluation and habilitation of these vulnerable infants is warranted. National follow-up guidelines need to be developed and implemented.
Source: BMJ Open
Institutions: University of Gothenburg, Karolinska University Hospital, Karolinska Institutet, Linköping University, Uppsala University, Sahlgrenska University Hospital, Region Västra Götaland, Skåne University Hospital, Umeå University, Region Jönköpings län, Ryhov Hospital Jönköping, Boston Children's Hospital, Harvard University
Language: English
Subfield: Radiology, Nuclear Medicine and Imaging
Field: Medicine
Domain: Health Sciences
Open Access status: gold
Estimated APC paid: $1,839
Funders: Ögonfonden, Göteborgs Läkaresällskap, Medicinska Forskningsrådet, De Blindas Vänner, National Institutes of Health, Intellectual and Developmental Disabilities Research Center, Medical Research Council, National Eye Institute, Eunice Kennedy Shriver National Institute of Child Health and Human Development
Awards: G1554073778, G3916677169, Boston Intellectual and Developmental Disabilities Research Center, Glucose/lipid metabolism and vessel development in phase I ROP, Boston Children's Hospital/HMS Intellectual and Developmental Disabilities Research Center, Dietary control of angiogenesis in retinopathy models
OpenAlex ID: W4289597277