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. 2022 Jan 4;5(1):e2145702.
doi: 10.1001/jamanetworkopen.2021.45702.

Functional Ophthalmic Factors Associated With Extreme Prematurity in Young Adults

Saurabh Jain  1 , Peng Yong Sim  1   2 , Joanne Beckmann  3 , Yanyan Ni  3 , Nabil Uddin  4 , Bronia Unwin  1 , Neil Marlow  3
Affiliations

Functional Ophthalmic Factors Associated With Extreme Prematurity in Young Adults

Saurabh Jain et al. JAMA Netw Open. .

Erratum in

  • Error in Byline.
    [No authors listed] [No authors listed] JAMA Netw Open. 2022 Apr 1;5(4):e2211768. doi: 10.1001/jamanetworkopen.2022.11768. JAMA Netw Open. 2022. PMID: 35446402 Free PMC article. No abstract available.

Abstract

Importance: Children born preterm (<37 weeks' gestation) have a higher risk of visual impairment and ocular morbidities compared peers born at full term. However, the long-term ocular sequelae in adulthood for those born extremely preterm (EP), who have the highest risk of neonatal retinopathy, are unknown.

Objective: To evaluate visual function and ocular morbidity in young adults born EP compared with controls born full term.

Design, setting, and participants: This prospective cohort study of a geographically based birth cohort in the UK and Ireland born from March 1 through December 31, 1995, included 128 participants aged 19 years (born at 22-25 weeks' gestation) and 65 age-matched controls born at full term. Statistical analysis was performed from March 1, 2020, to November 26, 2021.

Exposures: Participants underwent eye examinations as part of a comprehensive outcome evaluation.

Main outcomes and measures: Best-corrected visual acuity, refractive status, contrast sensitivity, color vision, prevalence of strabismus and nystagmus, and patient-reported visual function, measured using the Health Utilities Index Mark 3.

Results: The study comprised 128 participants (256 eyes; 68 female participants [53%]; mean [SD] age, 19.3 [0.5] years) and 65 age-matched controls born at full term (130 eyes; 40 female participants [62%]; mean [SD] age, 19.2 [0.5] years). Compared with control eyes, the mean (SD) best-corrected visual acuity among eyes in the EP group was significantly worse (monocular vision: -0.06 [0.14] logMAR in the control group vs 0.14 [0.38] logMAR in the EP group; P < .001; binocular vision: -0.14 [0.15] logMAR in the control group vs 0.06 [0.37] logMAR in the EP group; P < .001). Participants in the EP group had a significantly higher prevalence of strabismus (36% [46 of 127] vs 0%; P < .001), abnormal ocular motility (15% [19 of 125] vs 0%; P < .001), and nystagmus (13% [16 of 127] vs 0%; P < .001) than the control group. No significant differences between participants in the EP group and controls were observed for refractive error, contrast sensitivity, color vision, or patient-reported visual function. Among the participants in the EP group, 48% of eyes (120 of 250) had no retinopathy of prematurity (ROP), 39% (98 of 250) had ROP not requiring neonatal treatment, and 13% (32 of 250) received cryotherapy or laser ablation for ROP. Within the EP group, there was no significant difference in binocular visual function parameters, prevalence of ocular morbidity, and patient-reported visual function by neonatal ROP status.

Conclusions and relevance: Extreme prematurity is associated with an increased prevalence of visual and ocular deficits in young adulthood; this study suggests that, for individuals born EP, visual and ocular deficits appear to be partially independent of ROP status in the neonatal period but reports similar overall visual function.

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Conflict of interest statement

Conflict of Interest Disclosures: Dr Marlow reported receiving personal fees for serving as a consultant for Shire, Takeda, and Novartis; receiving partial funding from the Department of Health’s National Institute for Health Research Biomedical Research Centre’s funding scheme at UCLH/UCL; and receiving grants from Medical Research Council Programme Grant during the conduct of the study. No other disclosures were reported.

Figures

Figure.
Figure.. Monocular Best-Corrected Visual Acuity (BCVA) Among Participants Born Extremely Preterm (EP) by Neonatal Retinopathy of Prematurity (ROP) Status and Comparator Participants at 19 Years of Age
Horizontal bars indicate the median for each group.
See this image and copyright information in PMC

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