Visual function is reduced in young adults formerly born prematurely: a population-based study

Abstract

AimsTo assess visual function in young adults born preterm and compare with full-term individuals of the same age.MethodsYoung adults, born preterm (birth weight ≤1500 g) in 1988–1990, previously included in a population-based study on the incidence of retinopathy of prematurity (ROP) in Stockholm County, Sweden were included. A control group of participants born at term, in the same area during the same time period, was used for comparison. Best-corrected visual acuities were assessed at distance and near with logMAR charts. Distance visual acuity was also measured with single symbols to calculate crowding. Visual fields were measured with Humphrey 24-2 and the mean deviation was noted. Contrast sensitivity was assessed with Vistech contrast sensitivity test and the area under the curve was calculated.ResultsFifty-nine preterm (females 37) and 44 full-term (females 18) individuals were included. All individuals were between 25 and 29 years of age. Preterm individuals had significantly lower distance visual acuity (mean −0.08 (SD 0.11) vs −0.14 (SD 0.07) logMAR, p=0.009), near visual acuity (mean −0.08 (SD 0.11) vs −0.13 (SD 0.06) logMAR, p=0.049), mean deviation (mean −1.09 (SD 1.13) vs −0.80 (SD 1.03) dB, p=0.05) and contrast sensitivity (mean 2.02 (SD 0.19) vs 2.16 (SD 0.14), p<0.001) in the better eye compared with full-term individuals. The differences in distance visual acuity and contrast sensitivity were also evident after excluding persons with previous ROP and neurological complications. In multivariable analyses, treated ROP was a risk factor for reduced near visual acuity and visual fields.ConclusionVisual function seems to be reduced in prematurely born individuals even in adulthood. The reason may be prematurity per se since individuals without previous ROP or neurological complications are also affected.SynopsisVisual function, assessed as visual acuity, visual fields and contrast sensitivity, was reduced in young adults born preterm and previously included in a population-based study on the incidence of retinopathy of prematurity, as compared with controls.

Visual‐motor functions are affected in young adults who were born premature and screened for retinopathy of prematurity

“…In the present study, an extensive ophthalmological examination was performed, 17 ing, but also cognitively. 19 Contrast sensitivity, which is an important part of visual function, may be affected in persons with brain lesions.…”

“…Best‐corrected distance VA was measured monocularly with the logarithmic Early Treatment Diabetic Retinopathy Study chart and the best‐corrected near VA was estimated binocularly with the logarithmic Near Visual Acuity Early Treatment Diabetic Retinopathy Study Chart. Contrast sensitivity was assessed monocularly with the Vistech Contrast Sensitivity Test System (VCTS 6500) (Vistech Consultants), and the logarithmic values were used to calculate the area under the curve 17 . Furthermore, a comprehensive ophthalmological examination was performed including cover test, motility, anterior and posterior segment and refraction during cycloplegia.…”

Refraction and its development in young adults born prematurely and screened for retinopathy of prematurity

“…The present study is a long-term follow-up study of the Swedish cohort, which was the only one of the cohorts mentioned above, born after the introduction of treatment for ROP. The visual function and visual perception have previously been reported (Petursdottir et al 2020;P etursd ottir et al 2020). In the present study, the aim was to examine the refraction and refractive development in prematurely born individuals screened for ROP in the neonatal period and thereafter followed from infancy, childhood and school age up to young adulthood.…”

Clinical spectrum of blunted foveal contour

“…ROP is a disorder that affects the maturation of the retinal vasculature causing delayed and anomalous vascularization in premature infants. 36 – 38 Higher incidences of strabismus, cataracts, glaucoma, retinal detachment, macular ectopia, and decreased VA have been described. 9 , 36 – 38 Patients with a history of prematurity, with or without a diagnosis of ROP, and with or without macular ectopia, may show a characteristic blunting of the foveal contour.…”

“… 36 – 38 Higher incidences of strabismus, cataracts, glaucoma, retinal detachment, macular ectopia, and decreased VA have been described. 9 , 36 – 38 Patients with a history of prematurity, with or without a diagnosis of ROP, and with or without macular ectopia, may show a characteristic blunting of the foveal contour. Patients born prematurely may have retention of the inner retinal layers at the foveal center with ONL widening and photoreceptor elongation, which is typically asymptomatic with normal or near-normal VA. 9 , 18 , 19 , 39 Clinical examples are shown in Figures 6 and 7 .…”