title: Ophthalmologic outcome at 30 months' corrected age of a prospective Swedish cohort of children born before 27 weeks of gestation: the extremely preterm infants in sweden study.
abstract: OBJECTIVE
  Follow-up at 30 months' corrected age reveals eye and visual problems in one-third of children born extremely prematurely (<27 weeks' gestation).
  
  
  OBJECTIVE
  To investigate the ophthalmologic outcome of extremely preterm children at 30 months' corrected age. DESIGN, SETTING, AND PARTICIPANTS A prospective, population-based follow-up study (Extremely Preterm Infants in Sweden Study [EXPRESS]) was conducted in Sweden. The population included extremely preterm infants (<27 weeks' gestation) born in Sweden between 2004 and 2007, of whom 491 survived until age 2.5 years. Screening for retinopathy of prematurity (ROP) was performed in the neonatal period. At 30 months' corrected age, an ophthalmologic assessment was performed in 411 of 491 children (83.7%).
  
  
  METHODS
  Visual acuity, manifest strabismus, and refractive errors were evaluated.
  
  
  RESULTS
  Visual impairment was identified in 3.1% of the children, and 1.0% were blind. Refractive errors, defined as myopia less than -3 diopters (D), hypermetropia greater than +3 D, astigmatism 2 D or more, and/or anisometropia 2 D or more, were found in 25.6% of the children, and 14.1% had manifest strabismus. There were significant associations between visual impairment and treated ROP (P = .02), cognitive disability (P < .001), and birth weight (P = .02). Multiple regression analyses revealed significant associations between strabismus and treated ROP (P < .001), cognitive disability (P < .01), and cerebral palsy (P = .02). Refractive errors were significantly correlated with severity of ROP (right eye, P < .001; left eye, P < .01). Children who had been treated for ROP had the highest frequency (69.0%) of eye and visual abnormalities.
  
  
  CONCLUSIONS
  One-third of the extremely prematurely born children in this study had some kind of eye or visual problems, such as visual impairment, strabismus, or major refractive error. Despite being born extremely preterm, the present cohort has a similar prevalence of blindness and visual impairment as in previous Swedish cohorts of children born less prematurely.
authors: Department of Neuroscience, Ophthalmology, University Hospital, Uppsala, Sweden.
authors: Gerd E
authors: GE
authors: Holmström
authors: Centre of Reproductive Epidemiology, Lund University, Lund, Sweden.
authors: Karin
authors: K
authors: Källen
authors: Section of Pediatric Ophthalmology, The Queen Silvia Children's Hospital, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden.
authors: Ann
authors: A
authors: Hellström
authors: Department of Clinical and Experimental Medicine, Linköping University, Linköping, Sweden.
authors: Peter G
authors: PG
authors: Jakobsson
authors: Department of Women's and Children's Health, Section for Pediatrics, Uppsala University, Uppsala, Sweden6Department of Pediatrics, Institute of Clinical Sciences, Umeå University, Umeå, Sweden.
authors: Fredrik
authors: F
authors: Serenius
authors: Department of Psychology, Lund University, Lund, Sweden.
authors: Karin
authors: K
authors: Stjernqvist
authors: Department of Ophthalmology, Lund University Hospital, Lund, Sweden.
authors: Kristina
authors: K
authors: Tornqvist
mesh_terms: D001766:Blindness / Q000453:epidemiology*; D002675:Child, Preschool; D015331:Cohort Studies; D005260:Female; D005500:Follow-Up Studies; D005865:Gestational Age; D006801:Humans; D052577:Infant, Extremely Low Birth Weight; D062071:Infant, Extremely Premature; D008297:Male; D011446:Prospective Studies; D012030:Refractive Errors / Q000453:epidemiology*; D012178:Retinopathy of Prematurity / Q000453:epidemiology*; D013285:Strabismus / Q000453:epidemiology*; D013548:Sweden / Q000453:epidemiology; D015354:Vision, Low / Q000453:epidemiology*; D014792:Visual Acuity; D019987:Persons with Visual Disabilities / Q000706:statistics & numerical data*