Strabismus in Premature Infants in the First Year of Life

Bremer, Don L.; Palmer, Earl A.; Fellows, Rae R.; Baker, John D.; Hardy, Robert J.; Tung, Betty; Rogers, Gary L.

doi:10.1001/archopht.116.3.329

Cited by 89 publications

(34 citation statements)

References 10 publications

(12 reference statements)

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“…Certainly, it is well accepted that on average, twins are more likely to be born premature and have lower birth weights than singleton pregnancies (Kiely, 1990;Min et al, 2000). Low birth weight has been found to be associated with a three-to four-fold increased risk of strabismus (Bremer et al, 1998;Robaei et al, 2006), potentially accounting for higher prevalence in our study.…”

Section: Discussionmentioning

confidence: 49%

“…Neonatal risk factors such as low birth weight and prematurity may be associated with the disorder developing in childhood (Bremer et al, 1998;Chew et al, 1994;Keith & Kitchen, 1983;Robaei et al, 2006;Torp-Pedersen et al, 2010;Williams et al, 2008). This is supported by the fact that twins, commonly born premature and with low birth weight, have a higher prevalence of strabismus than the general population (Wilmer & Backus, 2009).…”

mentioning

confidence: 99%

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Heritability of Strabismus: Genetic Influence Is Specific to Eso-Deviation and Independent of Refractive Error

et al. 2012

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Strabismus represents a complex oculomotor disorder characterized by the deviation of one or both eyes and poor vision. A more sophisticated understanding of the genetic liability of strabismus is required to guide searches for associated molecular variants. In this classical twin study of 1,462 twin pairs, we examined the relative influence of genes and environment in comitant strabismus, and the degree to which these influences can be explained by factors in common with refractive error. Participants were examined for the presence of latent ('phoria') and manifest ('tropia') strabismus using cover-uncover and alternate cover tests. Two phenotypes were distinguished: eso-deviation (esophoria and esotropia) and exo-deviation (exophoria and exotropia). Structural equation modeling was subsequently employed to partition the observed phenotypic variation in the twin data into specific variance components. The prevalence of eso-deviation and exo-deviation was 8.6% and 20.7%, respectively. For eso-deviation, the polychoric correlation was significantly greater in monozygotic (MZ) (r = 0.65) compared to dizygotic (DZ) twin pairs (r = 0.33), suggesting a genetic role (p = .003). There was no significant difference in polychoric correlation between MZ (r = 0.55) and DZ twin pairs (r = 0.53) for exo-deviation (p = .86), implying that genetic factors do not play a significant role in the etiology of exo-deviation. The heritability of an eso-deviation was 0.64 (95% CI 0.50-0.75). The additive genetic correlation for eso-deviation and refractive error was 0.13 and the bivariate heritability (i.e., shared variance) was less than 1%, suggesting negligible shared genetic effect. This study documents a substantial heritability of 64% for eso-deviation, yet no corresponding heritability for exo-deviation, suggesting that the genetic contribution to strabismus may be specific to eso-deviation. Future studies are now needed to identify the genes associated with eso-deviation and unravel their mechanisms of action.

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Section: Discussionmentioning

confidence: 49%

mentioning

confidence: 99%

Heritability of Strabismus: Genetic Influence Is Specific to Eso-Deviation and Independent of Refractive Error

et al. 2012

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“…41,[43][44][45][46][47] This variation has implications on the planning of long-term surveillance and care for low birth weight infants, in terms of when to assess the child. It would be beneficial if risk factors for the development of strabismus were identified, to minimise assessments required for maximum capture.…”

Section: Strabismusmentioning

confidence: 99%

“…It would be beneficial if risk factors for the development of strabismus were identified, to minimise assessments required for maximum capture. The increased incidence of strabismus in children born prematurely has been attributed, either wholly or in part, to ROP, 43,48 increase in refractive error, 49 and neurological impairment. 44 However, these factors are inter-related and univariate analysis may simply be detecting confounding variables.…”

Section: Strabismusmentioning

confidence: 99%

Ophthalmological problems associated with preterm birth

O’Connor

Wilson

Fielder

2007

Eye

140

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As survival of preterm infants improves, the long-term care of consequent ophthalmic problems is an expanding field. Preterm birth can inflict a host of challenges on the developing ocular system, resulting in the visual manifestations of varied significance and pathological scope. The ophthalmic condition most commonly associated with preterm birth is retinopathy of prematurity, which has the potential to result in devastating vision loss. However, the visual compromise from increased incidence of refractive errors, strabismus, and cerebral vision impairment has significant impact on visual function, which also has influence on other developmental aspects including psychological and educational. In this review, the normal ocular development is discussed, aiming to exemplify the impact of early exteriorisation on one of the more naive organs of prematurity. This is then related to the incidence and visual consequences of many types of deficit, including refractive error, strabismus, and loss of visual function in preterm populations, with comparisons to term infant studies. Often these conditions are linked with causal and resultant factors being impossible to segregate, but the common factor of increased rates of all types of ophthalmic deficits demonstrates that children born prematurely are indeed premature for life.

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“…In the largest ophthalmological outcome study of low birthweight infants, 2499 children were examined and 200 (14.7%) were strabismic by the end of the first year of life [Bremer et al, 1998]. Infants who develop acute ROP are at increased risk of developing strabismus [Bremer et al, 1998;O'Keefe et al, 2001].…”

Section: Strabismusmentioning

confidence: 99%

Ophthalmological problems of the premature infant

Repka

2002

Ment. Retard. Dev. Disabil. Res. Rev.

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Preterm infants are more likely than term infants to have significant abnormalities of all parts of the visual system leading to reduced vision. The most common problem is retinopathy of prematurity (ROP). The frequency and severity of this disorder is inversely related to gestational age. Damage ranges from minor to catastrophic. Preterm infants also have higher rates of amblyopia, strabismus, refractive error, and cortical visual impairment. The later problem is largely associated with neonatal brain injury. Years later, these children may develop glaucoma and retinal detachments.

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Strabismus in Premature Infants in the First Year of Life

Cited by 89 publications

References 10 publications

Heritability of Strabismus: Genetic Influence Is Specific to Eso-Deviation and Independent of Refractive Error

Heritability of Strabismus: Genetic Influence Is Specific to Eso-Deviation and Independent of Refractive Error

Ophthalmological problems associated with preterm birth

Ophthalmological problems of the premature infant

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