Ophthalmic outcomes in children exposed to opioid maintenance treatment in utero: A systematic review and meta-analysis

Hemmati, Zeynab; Conti, Aldo Alberto; Baldacchino, Alex

doi:10.1016/j.neubiorev.2022.104601

Cited by 6 publications

(8 citation statements)

References 48 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Specifically, the polydrug exposure and the absence of a long-term observance make unclear the real effect of methadone on visual system and uncertain whether visual abnormalities are transient or the consequence of a teratogenic effect. 6 Herein, we reported the visual dysfunctions observed in two subjects, exposed only to methadone in utero and followed up for 11 years.…”

Section: Discussionmentioning

confidence: 99%

“…Along with pre-and perinatal disturbances (such as premature labor, neonatal abstinence syndrome, and other complications including meconium aspiration, jaundice, feeding difficulties) 8 and adverse neurodevelopmental outcomes (cognitive and motor deficits), 6 methadone exposure has been associated with abnormalities in visual functioning. However, a recent meta-analysis 6 could not confirm a causal relationship between in utero opioid exposure and eye abnormalities for several confounding variables and limitations of the studies. Specifically, the polydrug exposure and the absence of a long-term observance make unclear the real effect of methadone on visual system and uncertain whether visual abnormalities are transient or the consequence of a teratogenic effect.…”

Section: Discussionmentioning

confidence: 99%

“…However, these data do not allow extracting the real effect of methadone on visual function for: (1) the enrollment of subjects exposed to polydrug use in utero and (2) the lack of long-term followups. 6 In this study, we described the characteristics of the neurovisual profile and the long-term visual outcome in two infants with congenital nystagmus, solely exposed to methadone in utero.…”

Section: Introductionmentioning

confidence: 99%

See 2 more Smart Citations

Long-Term Visual and Neurodevelopmental Outcomes in Two Children with Congenital Nystagmus Secondary to Methadone Exposure In utero

Galli,

Loi,

Franzoni

et al. 2023

Neuropediatrics

View full text Add to dashboard Cite

Methadone is used as a substitute for illicit opioids during pregnancy. However, the real effect of this molecule on visual and neurodevelopmental outcomes of the children exposed is not fully understood, since studies considered subjects born to polydrug-dependent mothers and followed for few months/years.We report the long-term outcomes of two infants with congenital nystagmus solely exposed to methadone in utero. Neurological and neurovisual evaluations were performed every year from the first year of life to 11 years of age. One child was diagnosed with developmental coordination disorder. Both cases presented with ophthalmologic (refractive errors), oculomotor (nystagmus and fixation, smooth pursuit, and saccades dysfunctions), and perceptive problems (reduced visual acuity and contrast sensitivity). While nystagmus and other oculomotor dysfunctions remained stable over time, visual acuity and contrast sensitivity improved; refractive errors worsened and required corrective lenses. Both children showed normal neurodevelopmental and cognitive profile.This report highlights the long-term visual and developmental outcomes of two children exclusively exposed to methadone underlining the possibility of a visual dysfunction and motor coordination disorder. These observations prompt the need to investigate prenatal drug exposure as a cause of congenital nystagmus.

show abstract

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

Long-Term Visual and Neurodevelopmental Outcomes in Two Children with Congenital Nystagmus Secondary to Methadone Exposure In utero

Galli,

Loi,

Franzoni

et al. 2023

Neuropediatrics

View full text Add to dashboard Cite

show abstract

“…Previous studies in this field have raised doubt about a possible causal relationship between prenatal OMT exposure and adverse visual outcome, due to the high prevalence of polydrug use in OMT pregnant women (Hemmati et al, 2022; Midtlyng & Høiseth, 2016). The majority of the OMT women in this study were closely monitored during pregnancy (including regular urine analyses), in line with the national follow‐up programme.…”

Section: Discussionmentioning

confidence: 99%

“…Three recent review articles (Boardman et al, 2022; Hemmati et al, 2022; Lambert & Peeler, 2019) address the need for more long‐term follow‐up studies on visual outcome in a larger scale, including studies comparing exposure to methadone vs. buprenorphine (Kornør et al, 2019; McGlone et al, 2013; Suarez et al, 2022).…”

Section: Introductionmentioning

confidence: 99%

Visual function in Norwegian children aged 5–13 years with prenatal exposure to opioid maintenance therapy: A case–control study

Aslaksen,

Vikesdal,

Voie

et al. 2023

Acta Ophthalmologica

View full text Add to dashboard Cite

PurposeTo assess various aspects of visual function in school children prenatally exposed to opioid maintenance therapy (OMT) and to explore possible outcome differences between prenatal methadone and buprenorphine exposure.MethodsIn a cross‐sectional case–control study, 63 children aged 5–13 years with prenatal OMT exposure were compared with 63 age‐ and gender‐matched, non‐exposed controls regarding important visual parameters, such as visual acuity, orthoptic status, refractive state, colour vision, and visual field.ResultsThe OMT‐exposed children had significantly poorer visual acuity, both for the best eye, the worst eye and binocularly. Two children had mild visual impairment. Manifest strabismus was more frequent in the OMT group, 30%, vs. 4.8% in the control group. The most frequent types of strabismus were accommodative esotropia and intermittent exotropia. Manifest nystagmus was present in 10 (16%) of the exposed children compared to one among the non‐exposed children. The accommodative amplitude was decreased in the OMT group compared to the controls. After adjusting for polydrug exposure and SGA (small‐for‐gestational‐age), the between‐group differences in visual acuity, strabismus, and nystagmus remained. The methadone‐exposed children had poorer visual acuity, increased frequency of strabismus and a higher percentage of nystagmus, hypermetropia and astigmatism compared to the buprenorphine‐exposed children.ConclusionsSchool‐age children exposed to methadone or buprenorphine in utero had a higher prevalence of strabismus and nystagmus, and a lower visual acuity and accommodation amplitude. Buprenorphine exposure was associated with more favourable results than methadone exposure on most visual outcome measures and should be the preferred substance in OMT.

show abstract

Understanding vision outcomes in children with history of prenatal opioid exposure: a single-center pilot study

Herman,

Finton,

Yoo

et al. 2024

J Perinatol

View full text Add to dashboard Cite

Ophthalmic outcomes in children exposed to opioid maintenance treatment in utero: A systematic review and meta-analysis

Cited by 6 publications

References 48 publications

Long-Term Visual and Neurodevelopmental Outcomes in Two Children with Congenital Nystagmus Secondary to Methadone Exposure In utero

Long-Term Visual and Neurodevelopmental Outcomes in Two Children with Congenital Nystagmus Secondary to Methadone Exposure In utero

Visual function in Norwegian children aged 5–13 years with prenatal exposure to opioid maintenance therapy: A case–control study

Understanding vision outcomes in children with history of prenatal opioid exposure: a single-center pilot study

Contact Info

Product

Resources

About