Pétursdóttir Dýrleif, Holmström Gerd, Larsson Eva
Department of Neuroscience/Ophthalmology, Uppsala University, Uppsala, Sweden.
Acta Ophthalmol. 2022 May;100(3):e791-e797. doi: 10.1111/aos.14987. Epub 2021 Jul 26.
The aim of the study was to evaluate strabismus, stereoacuity, accommodation and convergence in prematurely born young adults; screened for retinopathy of prematurity in the neonatal period and compare with term-born individuals of the same age.
The study participants included 59 prematurely born individuals with a birthweight of ≤1,500 grams and 44 term-born controls, all born during 1988-1990 in Stockholm County, Sweden. Ocular alignment was assessed with a cover test, stereoacuity with the TNO stereo test and the amplitude of accommodation and the near point of convergence with the Royal Air Force Rule.
Seven of 59 (12%) preterms had manifest strabismus, 4/59 (7%) had esotropia and 3/59 (5%) exotropia. One of 44 (2%) controls had esotropia; no other controls had manifest strabismus. Stereoacuity was within normal limits in 38/59 (64%) preterms and 43/44 (98%) controls, p < 0.01; the difference remained after excluding those with strabismus. A neurological complication at 2.5 years of age was the strongest risk factor for subnormal stereoacuity within the preterm group after excluding those with strabismus. The mean amplitude of accommodation was poorer in the preterms than the controls in better (p < 0.05) and worse eyes (p < 0.05). The preterms were more likely to have an amplitude of accommodation below the minimum, according to Hofstetter's equation. There were no differences between the groups regarding the near point of convergence.
Prematurely born young adults had a higher prevalence of strabismus, reduced stereoacuity and worse amplitude of accommodation than term-born controls.
本研究旨在评估早产青年的斜视、立体视锐度、调节和集合功能；这些早产青年在新生儿期接受过早产儿视网膜病变筛查，并与同龄足月儿进行比较。
研究参与者包括59名出生体重≤1500克的早产儿和44名足月儿对照，他们均于1988年至1990年在瑞典斯德哥尔摩县出生。采用遮盖试验评估眼位，用TNO立体视觉测试评估立体视锐度，用皇家空军法则评估调节幅度和集合近点。
59名早产儿中有7名（12%）有明显斜视，4/59（7%）为内斜视，3/59（5%）为外斜视。44名对照中有1名（2%）为内斜视；其他对照均无明显斜视。38/59（64%）的早产儿和43/44（98%）的对照立体视锐度在正常范围内，p < 0.01；排除斜视患者后差异仍然存在。在排除斜视患者后的早产组中，2.5岁时的神经并发症是立体视锐度低于正常的最强危险因素。早产儿较好眼（p < 0.05）和较差眼（p < 0.05）的平均调节幅度均低于对照组。根据霍夫施泰特公式，早产儿更有可能调节幅度低于最小值。两组在集合近点方面无差异。
与足月儿对照相比，早产青年斜视患病率更高，立体视锐度降低，调节幅度更差。
