Department of Neuroscience, Ophthalmology, University Hospital, Uppsala, Sweden.
Centre of Reproductive Epidemiology, Lund University, Lund, Sweden.
JAMA Ophthalmol. 2014 Feb;132(2):182-9. doi: 10.1001/jamaophthalmol.2013.5812.
Follow-up at 30 months' corrected age reveals eye and visual problems in one-third of children born extremely prematurely (<27 weeks' gestation).
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%).
Visual acuity, manifest strabismus, and refractive errors were evaluated.
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.
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.
在矫正年龄 30 个月时，有三分之一的极早产儿（<27 周妊娠）会出现眼部和视觉问题。
调查矫正年龄 30 个月时极早产儿的眼科结局。
设计、地点和参与者：一项前瞻性、基于人群的随访研究（瑞典极早产儿研究 [EXPRESS]）在瑞典进行。该人群包括 2004 年至 2007 年期间在瑞典出生的极早产儿（<27 周妊娠），其中 491 名婴儿存活至 2.5 岁。在新生儿期进行早产儿视网膜病变（ROP）筛查。在矫正年龄 30 个月时，对 491 名儿童中的 411 名（83.7%）进行了眼科评估。
评估视力、显性斜视和屈光不正。
3.1%的儿童存在视力障碍，1.0%的儿童失明。25.6%的儿童存在屈光不正，定义为近视< -3 屈光度（D）、远视> +3 D、散光 2 D 或以上、或屈光参差 2 D 或以上，14.1%的儿童存在显性斜视。视力障碍与治疗性 ROP（P =.02）、认知障碍（P <.001）和出生体重（P =.02）显著相关。多因素回归分析显示，斜视与治疗性 ROP（P <.001）、认知障碍（P <.01）和脑瘫（P =.02）显著相关。屈光不正与 ROP 的严重程度显著相关（右眼，P <.001；左眼，P <.01）。接受 ROP 治疗的儿童眼部和视觉异常发生率最高（69.0%）。
本研究中三分之一的极早产儿存在某种眼部或视觉问题，如视力障碍、斜视或主要屈光不正。尽管出生时极早产，但本队列的失明和视力障碍患病率与之前瑞典出生的非极早产儿队列相似。
