Department of Neuroscience, Ophthalmology, Uppsala University, Uppsala, Sweden.
Department of Woman and Children, Uppsala University, Uppsala, Sweden.
Acta Paediatr. 2018 May;107(5):822-830. doi: 10.1111/apa.14209. Epub 2018 Jan 25.
To identify possible predictive factors for visual problems at 6.5 years in children born very preterm.
During 2004-2007, all very preterm infants (gestational age [GA] <32 weeks) in Uppsala County, Sweden were screened for retinopathy of prematurity (ROP) neonatally; at four months, visual tracking was tested; at 2.5 years, visuospatial and cognitive tests were carried out. At 6.5 years, 84 preterm children and a reference group of 64 full-term children underwent ophthalmological testing.
Mean visual acuity (VA) did not differ between the groups, but subnormal VA (≤0.8) was more common in the preterm group (31% vs 14%; p < 0.05). More often than full-term children, preterm children had impaired contrast sensitivity (<0.5) (36% vs 19%; p < 0.05) and strabismus (8% vs 0%; p < 0.05). Low GA, ROP, intraventricular haemorrhage 3-4/periventricular leukomalacia and cognitive disability at 2.5 years predicted ophthalmological and visual problems at 6.5 years. Visual tracking ability at four months was not predictive of ophthalmological outcome.
Children born preterm had more ophthalmological problems at 6.5 years of age, including subtle dysfunctions. ROP, early brain injury and impaired cognitive function around 2.5 years predicted later ophthalmological dysfunctions.
确定早产儿在 6.5 岁时出现视觉问题的可能预测因素。
在 2004-2007 年期间，瑞典乌普萨拉县所有极早产儿（胎龄<32 周）均在新生儿期进行早产儿视网膜病变（ROP）筛查；在 4 个月时进行视觉跟踪测试；在 2.5 岁时进行视空间和认知测试。在 6.5 岁时，84 名早产儿和 64 名足月儿童参考组接受眼科检查。
两组平均视力（VA）无差异，但早产儿组（31%）视力低于正常（≤0.8）的比例高于足月组（14%）（p<0.05）。与足月儿童相比，早产儿更常见对比敏感度（<0.5）受损（36%比 19%）（p<0.05）和斜视（8%比 0%）（p<0.05）。较低的胎龄、ROP、3-4 级脑室内出血/脑白质软化症和 2.5 岁时的认知障碍预测 6.5 岁时的眼科和视觉问题。4 个月时的视觉跟踪能力不能预测眼科结局。
早产儿在 6.5 岁时存在更多的眼科问题，包括细微的功能障碍。ROP、早期脑损伤和 2.5 岁左右认知功能受损预测日后的眼科功能障碍。
