Prevalence and associated factors of strabismus in former preterm and full-term infants between 4 and 10 Years of age

Abstract

BackgroundLimited data exist collating most of the associated factors for strabismus in one analysis. The aim of this study was to assess the prevalence of strabismus and to analyse associated factors in former preterm and full-term infants.MethodsIn this cross-sectional study, 239 former preterm infants with gestational age (GA) ≤ 32 weeks and 264 former full-term born infants with GA ≥ 37 weeks underwent detailed ophthalmologic examination in the age of 4–10 years and perinatal data assessment for risk factor analysis. Ophthalmologic examinations included cover testing, best corrected visual acuity, cycloplegic objective refraction, slit lamp as well as fundus examinations. For association analysis with strabismus, the following data was collected and included in multivariable analysis: sex, age at examination, anisometropia, myopic and hyperopic refractive error (≥ 3 dioptres), astigmatism, birth weight percentile, gestational age, retinopathy of prematurity occurrence, maternal age at childbirth, mother smoking, breastfeeding < 3 months, artificial ventilation, intraventricular bleeding, and other perinatal adverse events.ResultsOverall, 4/264 (2%) full-term infants, 15/125 (12%) preterm-infants with GA 29–32 weeks without ROP, 13/59 (22%) preterm infants with GA ≤ 28 weeks without ROP and 14/55 (26%) with GA ≤ 32 weeks with retinopathy of prematurity were affected by strabismus. In the multivariable regression model strabismus was associated with GA (OR = 0.84 per week; p = 0.001), hyperopic refractive error (OR = 4.22; p = 0.002) and astigmatism (OR = 1.68; p = 0.02).ConclusionThis investigation highlights that low gestational age and refraction of the eye are independent risk factors for strabismus, while the other factors show less independent influence.

Association of low birth weight with myopic refractive error and lower visual acuity in adulthood: results from the population-based Gutenberg Health Study (GHS)

“…This phenomenon is frequently reported in systemic disorders, such as cardiovascular disease, obesity and diabetes 5–8. Several studies have shown that newborns with low BW show an increased risk of developing ocular comorbidities,9 higher myopic refractive error,10 astigmatism11 and visual dysfunction12–15 in childhood, particularly in infants with extreme prematurity and extreme low BW.…”

Maternal smoking during pregnancy and the risk of strabismus in offspring: a meta‐analysis

“…When the other study without confounder adjustment (Fieβ A et al. ) was removed, the combined result of the remaining studies was 1.46 (95% CI: 1.32–1.60). Then, we omitted the two studies, and the result had hardly changed (1.46; 95% CI: 1.32–1.61), which demonstrated the primary results were robust and stable.…”

“…After excluding the study conducted by Pathai et al (2010) and his colleagues, where no confounding factor was adjusted, we yielded a pooled OR of 1.45 (95% CI: 1.32-1.61). When the other study without confounder adjustment (Fieb A et al 2017) was removed, the combined result of the remaining studies was 1.46 (95% CI: 1.32-1.60). Then, we omitted the two studies, and the result had hardly changed (1.46; 95% CI: 1.32-1.61), which demonstrated the primary results were robust and stable.…”

A retrospective survey of strabismus surgery in a tertiary eye center in northern China, 2014-2019

“…It has been reported that prematurity and maternal smoking during pregnancy are associated with a higher risk of paediatric esotropia and exotropia [9]. Furthermore, strabismus was associated with gestational age, hyperopic refractive error and astigmatism [10]. Esotropia, with lower gestational age and a heavier placenta; exotropia, with a maternal history of previously treated hypertension and maternal use of recreational drugs during early pregnancy [11].…”