Ophthalmological follow-up in young adults born premature and screened for retinopathy of prematurity

Sammanfattning: Prematurely born children have a higher risk of ophthalmological and neurodevelopmental disorders than those born at term. There is a paucity of long-term prospective follow-up studies on the visual function of prematurely born adults. The current study reported the outcome of young adult individuals born after the introduction of treatment for retinopathy of prematurity (ROP).The aim of the study was to assess visual function, visual-motor integration, refraction and its development, as well as strabismus, stereoacuity, accommodation and convergence in prematurely born young adults.The participants were prematurely born, between 1 November 1988 and 31 October 1990, having a birth weight of ≤1,500 g, in Stockholm County, Sweden. These individuals were initially part of a prospective population-based study on the incidence of ROP in the neonatal period, followed until 3.5 years of age, and examined again at 10 years of age, together with a control group of term born individuals. At 25–29 years of age, 59 of the preterms and 44 controls underwent an extensive ophthalmological examination and a developmental test of visual-motor integration.The preterms had lower visual acuity than the controls at distance and near. Mean deviation of the visual field was reduced in preterms, as was contrast sensitivity. A crowding ratio of ≥1.5 was more prevalent in preterms. In a test of visual-motor integration, the preterms had inferior results compared to controls, in which a neurological complication at 2.5 years of age was the strongest risk factor. The preterms had greater values of myopia and hyperopia, as well as anisometropia and astigmatism, where the highest risk was found in preterms who had been treated for ROP. The spherical equivalent decreased around 1 D in both groups from 10 years to 25–29 years of age. Strabismus was found in 7/59 (12%) preterms and 1/44 (2%) controls. More preterms had subnormal stereoacuity, where the strongest risk factor was a neurological complication at 2.5 years of age. Preterms had worse amplitude of accommodation. No differences were found regarding convergence.Prematurely born individuals had reduced visual function, worse visual-motor integration, higher prevalence of refractive errors and strabismus, and worse stereoacuity than term born controls in young adulthood. These lifelong effects could be correlated to previous cryotherapy for ROP or neurological complications, but not always, suggesting a role of prematurity per se.