Department of Ophthalmology, Haukeland University Hospital, Bergen, Norway.
Acta Ophthalmol. 2012 Aug;90(5):422-7. doi: 10.1111/j.1755-3768.2010.02020.x. Epub 2010 Nov 2.
Progress in neonatal care has caused an increased survival of children born extremely preterm. The aims of this study were to examine the long-term visual function and ocular development in an unselected cohort of extremely preterm infants and relate the results to neonatal morbidity and long-term neurodevelopmental outcome.
All children with gestational age of 22-27 completed weeks or birth weight of 500-999 g born in the years 1999-2000 in two counties of Western Norway (n = 52) were invited to an eye examination that included visual acuity, refractive error, binocular function, accommodative amplitude and fundus examination. Cognitive function was assessed with the WPSSI-R test and motor abilities with the ABC movement test.
Neonatal morbidities and neurodevelopmental outcome were known for all, while 37 of the 52 children underwent the eye examination. None were blind or visually impaired, but 46% had subnormal visual acuity (logMAR ≥0.1). Ninety per cent were emmetropic or slightly hypermetropic (0 to +3D), while 10% had manifest and 51% latent strabismus. Performance IQ on the WPSSI-R test and ABC total score were associated with best visual acuity (p = 0.03 and p < 0.01, respectively). In a multiple linear regression model, visual acuity in the best eye was significantly associated with performance IQ (p = 0.03) and ABC total score (p = 0.02).
This study suggests a more favourable long-term prognosis on important ocular and visual parameters in survivors of extreme prematurity than expected from similar reports on children born less prematurely and that performance IQ and motor function are related to visual acuity.
新生儿护理的进步导致极早产儿的存活率提高。本研究旨在检查未经选择的极早产儿队列的长期视觉功能和眼部发育，并将结果与新生儿发病率和长期神经发育结果相关联。
1999 年至 2000 年，在挪威西部的两个县出生胎龄为 22-27 周或出生体重为 500-999 克的所有儿童（n=52）均被邀请接受眼部检查，包括视力、屈光不正、双眼功能、调节幅度和眼底检查。认知功能采用 WPSSI-R 测试进行评估，运动能力采用 ABC 运动测试进行评估。
所有儿童的新生儿发病率和神经发育结果均已知，而 52 名儿童中有 37 名接受了眼部检查。没有盲童或视力受损儿童，但 46%的儿童视力低于正常值（logMAR≥0.1）。90%为正视或轻度远视（0 至+3D），而 10%有显性斜视，51%有潜伏性斜视。WPSSI-R 测试的表现智商和 ABC 总评分与最佳视力相关（p=0.03 和 p<0.01）。在多元线性回归模型中，最佳眼视力与表现智商（p=0.03）和 ABC 总评分（p=0.02）显著相关。
本研究表明，与出生时间稍早的儿童相比，极早产儿的长期预后在重要的眼部和视觉参数方面更为有利，并且表现智商和运动功能与视力相关。
