Ocular features other than retinopathy of prematurity in the pre‐term infant

Abstract

218 premature infants born 1985-87 in Frederiksborg County were followed in the eye clinic, mainly due to the risk of developing retinopathy of prematurity (ROP). The median gestational age was 33 weeks, the median birth weight 1.750 g. ROP being analysed elsewhere, emphasis is on a) retinal haemorrhages (long-standing in 11) and vitreous bleeding (3 cases); b) the oval shape of the pre-term optic disc, considered a true finding and not merely an optical artifact; c) the pre-term presence of the optic disc cup, otherwise considered of about-term development; and d) refractive state, with myopia as a prevailing finding at post-conceptional ages shorter than 40 weeks. A shift towards hypermetropia became obvious after 2-3 months. Only 4 cases deserved the label myopia of prematurity, the criteria being early recording of ROP and persistent myopia (for more than 18-24 months).

Optic disc morphology in premature infants

“…In the above mentioned study on ocular features in premature infants by Fledelius,15 optic discs showed an elliptic contour and also a double contour of the disc margins, but both phenomena regressed within 1–2 years. In our study, the form of the optic discs significantly changed between the first and second examinations insofar that the discs were rounder but still highly oval.…”

“…In the present study, we found the double ring sign in a high proportion of eyes (75%), which remained unchanged between the two examinations. Fledelius15 described a double ring sign in 23% of cases and suggested that the double ring sign is a normal stage of disc development. In our study, the proportion of eyes with the double ring sign was considerably higher and did not regress up to the due date.…”

Refraction and visual acuity in a national Danish cohort of 4‐year‐old children of extremely preterm delivery

“…The entity is regarded a sequel to the metabolic turmoil associated to the preterm delivery, and childhood‐corrected visual acuity usually is below 1.0. Such lesional MOP should not be confused with the transient myopia observed shortly after delivery in preterms, which is physiological and associated to the ‘foetal’, more spherical shape of the lens (Fledelius ; Saunders et al. ; O'Connor et al.…”

Assessing Agreement of Clinical Estimation of Vertical Optic Disc Cupping against Retcam Assessment in the Premature Neonate and Prospective Observation for Changes

“…The optic nerve in a premature infant is not fully developed at the time of birth [17]. These changes range from continuing development and attrition of axons with their myelin sheaths and subsequent regression of the myelin sheath from the retina, occurring up to age 2 years [18]. Assault to the optic nerve during this development may result in irreversible changes [19].…”

“…Assault to the optic nerve during this development may result in irreversible changes [19]. This was observed in many studies [2][3][4][5]9,10,18,20]. The most observable aspect of this change is in the optic nerve head size and shape, cupdisc-ratio and neuro-retinal rim thinning.…”