Visual Function in School-Age Children with a History of Prematurity

Bo-Ram Hong, Johane M Robitaille, PhD FRCSC, Paul H Artes PhD MCOptom
Ophthalmology and Visual Sciences, Dalhousie University & IWK Childrens Hospital, Halifax, NS, Halifax Pediatric Vision Science Research Group (PVSRG, www.pvsrg.org) Purpose To compare visual function in children with a history of prematurity, with or without retinopathy (ROP), to that of full-term children. Methods We investigated 39 school-age children (24 girls, 15 boys, median age 10, IQR 9-12 years) born prematurely (gestational age <31 weeks) and 21 age-matched controls (13 girls, 8 boys). The premature participants were subdivided into those with mild ROP (stages 1 or 2 in zone 2), and those without ROP (stage 0). We investigated visual acuity (ETDRS chart), stereo-acuity (Frisby test), hyperacuity (Radial Deformation Acuity, Manchester RDA charts), and peripheral visual fields (Octopus 900). Results Except for a clinically unimportant 2-letter difference in visual acuity, we did not observe statistically significant or clinically meaningful differences in any of the visual functions between the three groups (Table 1). Most children completed the fully-automated kinetic perimetry of three isopters with similar performance levels as are expected in adults. Conclusions Mild ROP in pre-term children did not appear to cause visual problems in later childhood. Automated kinetic perimetry with the Octopus 900 may be a quantifiable and more widely available alternative to manual kinetic Goldmann perimetry and is feasible with school-age children. Table 1. Visual acuity, stereoacuity, hyperacuity, and visual field data in the three groups of children. (sec arc = seconds of arc; VA=visual acuity; RDA=radial deformation acuity) and mean radius (degrees) of I4e, I2e and I1e isopters. *Kruskal-Wallis rank-based comparison of groups test.

Mild ROP
n=15

Median IQR
Mean (SD)

log MAR 0.00 -0.03, 0.04

+0.02 (0.08)

VA

Stereo
sec arc 35 35, 55
48 (26)

log units 2.55 2.45, 2.63

2.53 (0.12)

RDA

I4e, deg 60 58, 62

60 (2)

Visual Fields
I2e, deg 41 40, 43
41 (4)

I1e, deg 26 23, 28

25 (4)

No ROP
n=24

Median IQR
Mean (SD)

-0.01 -0.06, 0.03

0.00 (0.06)

35 35, 55
50 (27)

2.57 2.49, 2.69

2.57 (0.14)

59 57, 63
58 (6)

42 39, 45
41 (5)

26 22, 28
25 (4)

Controls
n=21 P-value*

Median IQR
Mean (SD)

-0.04 -0.07, -0.01

-0.03 (0.06)

35 35, 55
46 (22)

2.59 2.49, 2.65

2.56 (0.12)

59 57, 60
59 (3)

40 37, 43
40 (4)

24 22, 26
24 (3)

0.02

0.58

0.67

0.99

0.36

0.36

Support This research was supported by the Nova Scotia Health Research Foundation (NSHRF), an IWK Graduate Studentship to the first author (BH), and unrestricted research grants by Haag-Streit and the OPI Foundation.