Long-term evaluation of refractive status and optical components in eyes of children born prematurely.
OBJECTIVE
To evaluate the refractive status and optical components in school age children born prematurely and to examine the risk factors associated with refractive errors.


METHODS
The participants were a cohort of children aged 7 to 9 years with gestational age less than 35 weeks or birth weight less than 1500 g. The participants' neonatal histories were reviewed; their refractive status and optical components were measured. The study results were compared with the results of age-matched children from a national survey.


RESULTS
Of the 108 children studied, 48 (44%) had retinopathy of prematurity (ROP); 29 (27%) had ROP ≥ stage 3. Compared with the control subjects, the study cases showed higher prevalence of myopia (48% vs. 29%), hyperopia (23% vs. 15%), and astigmatism (73% vs. 41%). Common ocular features included shallow anterior chamber depth (ACD), thick lenses, and steep corneal curvature. The hyperopic cases had the shortest axial length (AL), whereas the myopia cases had significantly shallower ACD and greater LT. Those with a history of ROP had more prominent changes in the anterior segment. Generalized estimating equations showed that refractive errors could be predicted by a combination of optical components.


CONCLUSIONS
In children born prematurely, the development of myopia is mainly influenced by anterior segment components, whereas hyperopia is mainly attributable to short AL. Astigmatism is primarily cornea-related. A combination of various optical components results in complicated refractive outcomes. The presence of ROP may be associated with significantly shorter ACD, thicker lens, and higher myopia and astigmatism. (ClinicalTrials.gov number, NCT01045616.).
Chen
Ta-Ching
TC
Department of Ophthalmology, National Taiwan University Hospital, Taipei, Taiwan.
Tsai
Tzu-Hsun
TH
Shih
Yung-Feng
YF
Yeh
Po-Ting
PT
Yang
Chang-Hao
CH
Hu
Fu-Chang
FC
Lin
Luke Long-Kuang
LL
Yang
Chung-May
CM
D000867:Anterior Chamber / Q000473:pathology*; D001699:Biometry; D002648:Child; D003315:Cornea / Q000473:pathology*; D005260:Female; D005500:Follow-Up Studies; D005865:Gestational Age; D006801:Humans; D007231:Infant, Newborn; D019102:Infant, Very Low Birth Weight; D007908:Lens, Crystalline / Q000473:pathology*; D008297:Male; D047928:Premature Birth / Q000503:physiopathology*; D012029:Refraction, Ocular; D012030:Refractive Errors / Q000503:physiopathology*; D012178:Retinopathy of Prematurity / Q000503:physiopathology*; D012189:Retrospective Studies