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. 1997 Mar;76(2):F82–F87. doi: 10.1136/fn.76.2.f82

Visual impairment in very low birthweight children

A Powls, N Botting, R Cooke, G Stephenson, N Marlow
PMCID: PMC1720628  PMID: 9135285

Abstract

AIMS—To compare the visual function of a cohort of very low birthweight (VLBW) children in early adolescence with that of their normal birthweight peers; to correlate visual impairment in this group with available perinatal data; and to examine the relation between the visual ability of VLBW children and their cognitive and motor skills.
METHODS—As part of a long term neurodevelopmental study, 137 VLBW children and 163 normal birthweight controls were visually assessed between the ages of 11 and 13 years. Their eyes were examined for strabismus and movement disorders, and the use of visual correction for refractive errors was noted. Measures were made of visual acuity, stereopsis, and contrast sensitivity. All children had standardised tests of motor ability and cognitive skills. Perinatal data, including cranial ultrasonography results, had been obtained from the children's notes. No data were available however, regarding retinopathy of prematurity as screening was not established when these infants were born.
RESULTS—On all measures, the visual function of the VLBW children was poorer than that of the controls. Reduced visual function was present in 63.5% of VLBW children compared with 36% of controls. Poor contrast sensitivity and strabismus were predictive of poor motor skills in the VLBW children. Poor contrast sensitivity and poor visual acuity (at 0.3 metres) were
 predictive of lower IQ. Low birthweight, intraventricular haemorrhage, intrauterine growth retardation and low 1 minute Apgar scores predicted reduced visual function.
CONCLUSIONS—VLBW children have a high incidence of impaired vision. Stereopsis and contrast sensitivity are useful additions to the screening of this high risk group. They identified impaired vision that was not detected by normal screening and were related to impaired neurodevelopmental outcome.

 Keywords: visual function; very low birthweight; cognitive impairment; motor skills; stereopsis; contrast sensitivity.

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Selected References

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  1. Abramov I., Hainline L., Lemerise E., Brown A. K. Changes in visual functions of children exposed as infants to prolonged illumination. J Am Optom Assoc. 1985 Aug;56(8):614–619. [PubMed] [Google Scholar]
  2. Burgess P., Johnson A. Ocular defects in infants of extremely low birth weight and low gestational age. Br J Ophthalmol. 1991 Feb;75(2):84–87. doi: 10.1136/bjo.75.2.84. [DOI] [PMC free article] [PubMed] [Google Scholar]
  3. Eken P., de Vries L. S., van der Graaf Y., Meiners L. C., van Nieuwenhuizen O. Haemorrhagic-ischaemic lesions of the neonatal brain: correlation between cerebral visual impairment, neurodevelopmental outcome and MRI in infancy. Dev Med Child Neurol. 1995 Jan;37(1):41–55. doi: 10.1111/j.1469-8749.1995.tb11931.x. [DOI] [PubMed] [Google Scholar]
  4. Fielder A. R., Moseley M. J., Ng Y. K. The immature visual system and premature birth. Br Med Bull. 1988 Oct;44(4):1093–1118. doi: 10.1093/oxfordjournals.bmb.a072291. [DOI] [PubMed] [Google Scholar]
  5. Fielder A. R., Robinson J., Shaw D. E., Ng Y. K., Moseley M. J. Light and retinopathy of prematurity: does retinal location offer a clue? Pediatrics. 1992 Apr;89(4 Pt 1):648–653. [PubMed] [Google Scholar]
  6. Fledelius H. C. Ophthalmic changes from age of 10 to 18 years. A longitudinal study of sequels to low birth weight. II. Visual acuity. Acta Ophthalmol (Copenh) 1981 Feb;59(1):64–70. doi: 10.1111/j.1755-3768.1981.tb06712.x. [DOI] [PubMed] [Google Scholar]
  7. Gallo J. E., Lennerstrand G. A population-based study of ocular abnormalities in premature children aged 5 to 10 years. Am J Ophthalmol. 1991 May 15;111(5):539–547. doi: 10.1016/s0002-9394(14)73695-5. [DOI] [PubMed] [Google Scholar]
  8. Gibson N. A., Fielder A. R., Trounce J. Q., Levene M. I. Ophthalmic findings in infants of very low birthweight. Dev Med Child Neurol. 1990 Jan;32(1):7–13. doi: 10.1111/j.1469-8749.1990.tb08461.x. [DOI] [PubMed] [Google Scholar]
  9. Haegerstrom-Portnoy G. New procedures for evaluating vision functions of special populations. Optom Vis Sci. 1993 Apr;70(4):306–314. doi: 10.1097/00006324-199304000-00009. [DOI] [PubMed] [Google Scholar]
  10. Hungerford J., Stewart A., Hope P. Ocular sequelae of preterm birth and their relation to ultrasound evidence of cerebral damage. Br J Ophthalmol. 1986 Jun;70(6):463–468. doi: 10.1136/bjo.70.6.463. [DOI] [PMC free article] [PubMed] [Google Scholar]
  11. Keen D. V., Pearse R. G. Birthweight between 14 and 42 weeks' gestation. Arch Dis Child. 1985 May;60(5):440–446. doi: 10.1136/adc.60.5.440. [DOI] [PMC free article] [PubMed] [Google Scholar]
  12. Keith C. G., Kitchen W. H. Ocular morbidity in infants of very low birth weight. Br J Ophthalmol. 1983 May;67(5):302–305. doi: 10.1136/bjo.67.5.302. [DOI] [PMC free article] [PubMed] [Google Scholar]
  13. Kushner B. J. Strabismus and amblyopia associated with regressed retinopathy of prematurity. Arch Ophthalmol. 1982 Feb;100(2):256–261. doi: 10.1001/archopht.1982.01030030258004. [DOI] [PubMed] [Google Scholar]
  14. Marlow N., Roberts L., Cooke R. Outcome at 8 years for children with birth weights of 1250 g or less. Arch Dis Child. 1993 Mar;68(3 Spec No):286–290. doi: 10.1136/adc.68.3_spec_no.286. [DOI] [PMC free article] [PubMed] [Google Scholar]
  15. McGinnity F. G., Bryars J. H. Controlled study of ocular morbidity in school children born preterm. Br J Ophthalmol. 1992 Sep;76(9):520–524. doi: 10.1136/bjo.76.9.520. [DOI] [PMC free article] [PubMed] [Google Scholar]
  16. McGinnity F. G., Halliday H. L. Perinatal predictors of ocular morbidity in school children who were very low birthweight. Paediatr Perinat Epidemiol. 1993 Oct;7(4):417–425. doi: 10.1111/j.1365-3016.1993.tb00423.x. [DOI] [PubMed] [Google Scholar]
  17. Nissenkorn I., Yassur Y., Mashkowski D., Sherf I., Ben-Sira I. Myopia in premature babies with and without retinopathy of prematurity. Br J Ophthalmol. 1983 Mar;67(3):170–173. doi: 10.1136/bjo.67.3.170. [DOI] [PMC free article] [PubMed] [Google Scholar]
  19. Page J. M., Schneeweiss S., Whyte H. E., Harvey P. Ocular sequelae in premature infants. Pediatrics. 1993 Dec;92(6):787–790. [PubMed] [Google Scholar]
  20. Powls A., Botting N., Cooke R. W., Marlow N. Motor impairment in children 12 to 13 years old with a birthweight of less than 1250 g. Arch Dis Child Fetal Neonatal Ed. 1995 Sep;73(2):F62–F66. doi: 10.1136/fn.73.2.f62. [DOI] [PMC free article] [PubMed] [Google Scholar]
  21. Quinn G. E., Dobson V., Repka M. X., Reynolds J., Kivlin J., Davis B., Buckley E., Flynn J. T., Palmer E. A. Development of myopia in infants with birth weights less than 1251 grams. The Cryotherapy for Retinopathy of Prematurity Cooperative Group. Ophthalmology. 1992 Mar;99(3):329–340. doi: 10.1016/s0161-6420(92)31968-2. [DOI] [PubMed] [Google Scholar]
  22. Robinson R., O'Keefe M. Follow-up study on premature infants with and without retinopathy of prematurity. Br J Ophthalmol. 1993 Feb;77(2):91–94. doi: 10.1136/bjo.77.2.91. [DOI] [PMC free article] [PubMed] [Google Scholar]
  23. Sebris S. L., Dobson V., Hartmann E. E. Assessment and prediction of visual acuity in 3- to 4-year-old children born prior to term. Hum Neurobiol. 1984;3(2):87–92. [PubMed] [Google Scholar]
  24. Snir M., Nissenkorn I., Sherf I., Cohen S., Ben Sira I. Visual acuity, strabismus, and amblyopia in premature babies with and without retinopathy of prematurity. Ann Ophthalmol. 1988 Jul;20(7):256–258. [PubMed] [Google Scholar]

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