[The appearance of refractive errors and eyeballs position disorders in the group of premature babies treated at the Chair and Clinic of Ophthalmology of the Pomeranian Medical University in the years 1999-2005]

Abstract

Introduction: Retinopathy of prematurity (ROP) is a disease of the retina and the vitreous body present in children prematurely born. In the groups of babies with retinopathy of prematurity as well as among in the group of babies without pathological lesions, however, with retinal immaturity, occurrence of complications in the form of refractive errors and abnormality in the eyeballs position can be observed. The aim of the study was to analyze the frequency of occurrence of hypermetropia, myopia, astigmatism and eyeballs position disorders in the form of strabismus and nystagmus in premature babies.

Material and methods: The study material consisted of 1052 newborns treated in the Outpatient Clinic of Ophthalmology for Premature Infants in Szczecin, between 1999-2005. Refractive errors were estimated, after cycloplegic retinoscopy (0.5% Tropicamidum and 2.5% Phenylephryni hydrochloridum). Refractive errors were recognized when hypermetropia was > or = +3.0 D, myopia > or = -0.5 D, astigmatism > or = 1.0 Dcyl. Among 65 babies of the analyzed group laser treatment of the retina was applied, the rest of the 987 infants were observed or have underwent a conservative treatment. The studied group of premature babies has been divided into the following subgroups: Group I--conservatively treated babies (n = 987), group II--diode laser treated babies (n = 65). The statistic analysis of refractive errors was done on the basis of Statistica v.7.1 [StatSoft, Inc. (2005). Statistica (data analysis system), version 7.1.]. The incidence of refractive errors was described with the help of chi-square test.

Results: Refractive errors were recognized among 695 babies (70.49%) from group I and in 49 babies (75.39%) from group II. In the group of 987 infants whom were not treated with laser but conservatively a more frequent occurrence ofhypermetropia and astigmatism was observed--655 babies (66.33%) and 202 (20.46%) respectively. Myopia was most common in the laser treated group of babies: 19 patients (29.23%). In this group astigmatism was present in 9 babies (13.84%). Eyeballs position disorders in the form of strabismus and nystagmus were more common in the group of babies treated with laser (29.23% and 9.23%) comparing with conservatively treated babies (10.63% and 1.63%) respectively.

Conclusions: Hypermetropia and astigmatism could be more often observed in the group of premature babies in whom pathological ocular fundus lesions or a low stage of advancement of retinopathy of prematurity susceptible to self-regression were not recognized. Myopia was more often identified in the group of babies with an active stage of retinopathy of prematurity as well as in those in whom laser treatment was required. Eyeballs position disorders in the form of strabismus and nystagmus were more frequent in the group of babies with an active stage of retinopathy of prematurity in whom diode laser treatment was applied.