Holmström G, el Azazi M, Kugelberg U
Department of Ophthalmology, Huddinge University Hospital, Karolinska Institute, Stockholm, Sweden.
Br J Ophthalmol. 1999 Feb;83(2):143-50. doi: 10.1136/bjo.83.2.143.
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).
A 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.
Poor 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.
The 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.
背景/目的：已知早产婴儿眼科疾病发病率较高。本研究旨在调查某一地理区域内早产婴儿群体的视力和眼位情况，包括患有和未患早产儿视网膜病变（ROP）的婴儿。
对出生体重1500克及以下的早产婴儿进行了为期3.5年的前瞻性群体眼科状况研究，在矫正年龄6、18、30和42个月时进行检查。使用线性视标测试视力。采用多元回归分析来分析视力不佳和斜视的独立危险因素。
2.5%（6/237）的儿童视力不佳（<0.3）。其中，只有两名（0.8%）有严重视力损害（<0.1）。斜视发生率为13.5%（31/229）。多元回归分析显示，接受冷冻治疗的ROP患儿和有神经并发症的患儿视力不佳和斜视风险最高。在无ROP或神经并发症病史的儿童中，34%的儿童视力<0.7，5.9%的儿童有斜视，相比之下，有ROP或神经并发症的儿童中这两个比例分别为61%和22%。
早产儿童视力低下和斜视的总体发生率高于同年龄足月人群。基于本研究，建议对所有接受ROP筛查的早产婴儿进行随访，并提出了一般指导原则。
