Visual Processing in Adolescents Born Extremely Low Birth Weight and/or Extremely Preterm

Abstract

BACKGROUND AND OBJECTIVES Ocular growth and development differs between preterm and term-born infants and may cause long-term negative consequences for visual function, but contemporary data on long-term visual outcomes in representative samples of the highest risk extremely low birth weight (ELBW, <1000 g birth weight) or extremely preterm (EP, <28 weeks’ gestation) survivors are lacking. Our objective was to compare visual functioning between ELBW/EP and normal birth weight (NBW, >2499 g birth weight) control adolescents. METHODS: Geographically determined cohort study of 228 consecutive ELBW/EP survivors born in the state of Victoria in 1991 and 1992, and 166 randomly selected NBW controls assessed between 14 and 20 years of age. Visual acuity, stereopsis, convergence, color perception, and visual perception were assessed and contrasted between groups. RESULTS: ELBW/EP subjects had significantly worse visual acuity with habitual correction in both the left and right eyes, and for the best eye (P < .001). The ELBW/EP adolescents also exhibited poorer stereopsis, odds ratio (OR) 3.22 (95% confidence interval [CI] 1.78 to 5.84), and convergence, OR 2.76 (CI 1.32 to 5.75) than controls, and more problems with visual perception, OR 3.09 (CI 1.67 to 5.71) after habitual correction. CONCLUSIONS: Despite advances in medical care improving the survival rate of high-risk ELBW/EP infants, visual morbidity is still relatively high compared with controls in late adolescence.

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

“…Similarly, an Australian study in late adolescents aged 14–20 years reported that participants with formerly extreme low BW and extreme preterm infants compared with normal BW infants had significantly worse visual acuities, poorer stereopsis and poorer convergence 16. There are limited data based on assessing the association of visual acuity and BW in adults with a particular lack of population-based data.…”

“…In several studies on late adolescents (age 14–20 years)16 and in a Danish study of 4300 conscripts,17 an association was observed between low BW and reduced visual acuity, whereas there is no population-based data for the impact far beyond childhood. Furthermore, varying data exist for the association with refractive error.…”

Vision in former very low birthweight young adults with and without retinopathy of prematurity compared with term born controls: the NZ 1986 VLBW follow-up study

“…In addition, a prospective, population-based study of extremely low birthweight (ELBW) children from Victoria, Australia, born in the era of ROP treatment, reported more problems in visual perception at age 14–20 years (OR 3.09) compared with controls 31. A subsequent MRI study in the same ELBW cohort reported alterations in both the optical radiation and visual cortex compared with controls, which may be related to the visual findings 32.…”

Visual Processing Disorder in Children

“…Certain studies recommend that low birth weight or extreme preterm birth can play a role. 3 It is also believed that minor traumatic brain injury could lead to visual processing issues, but then again there is no adequate evidences to completely support that concept. 4 It is also very difficult to identify visual processing issues in children.…”