title: Early Anesthesia Exposure and the Effect on Visual Acuity, Refractive Error, and Retinal Nerve Fiber Layer Thickness of Young Adults.
abstract: OBJECTIVE
  To investigate whether being anesthesia administered at least once in early life influenced 3 main proxies of visual function: visual acuity, refractive error, and optic nerve health in young adulthood.
  
  
  METHODS
  At age 20 years, participants of the Western Australian Pregnancy Cohort Study had comprehensive ocular examinations including visual acuity, postcycloplegic refraction, and multiple scans of the optic disc. We identified individuals who had at least 1 procedure requiring anesthesia during the first 3 years of life (between 1990 and 1994) and compared their visual outcomes with nonexposed individuals. We excluded 40 participants with strabismus or other ophthalmic disease or surgery and 136 with non-European background.
  
  
  RESULTS
  Of 834 participants, 15.2% (n = 127) were exposed to anesthesia at least once before age 3 years. In both exposed and nonexposed groups, median visual acuity (measured using the logarithm of the minimum angle of resolution [LogMAR] chart) was -0.06 LogMAR in the right eye and -0.08 LogMAR in the left eye (P > .05). Median spherical equivalent refractive error was +0.44 diopters (IQR -0.25, +0.63) and +0.31 diopters (IQR -0.38, +0.63) in the exposed and nonexposed group, respectively (P = .126). No difference was detected in mean global retinal nerve fiber layer thickness of the 2 groups (100.7 vs 100.1 μm, P = .830).
  
  
  CONCLUSIONS
  We were unable to demonstrate an association of exposure to anesthesia as a child with reduced visual acuity or increased myopia or thinning of retinal nerve fiber layer. These findings support the view that anesthesia is unlikely to impair visual development, but further work is needed to establish whether more subtle defects are present and repeated exposures have any effects.
authors.affiliation: Center for Ophthalmology and Visual Science, University of Western Australia, Lions Eye Institute, Perth, Western Australia, Australia.
authors.forename: Seyhan
authors.initials: S
authors.lastname: Yazar
authors.affiliation: Center for Ophthalmology and Visual Science, University of Western Australia, Lions Eye Institute, Perth, Western Australia, Australia; Center for Eye Research Australia, The University of Melbourne, Royal Victorian Eye and Ear Hospital, Melbourne, Victoria, Australia.
authors.forename: Alex W
authors.initials: AW
authors.lastname: Hewitt
authors.affiliation: Center for Ophthalmology and Visual Science, University of Western Australia, Lions Eye Institute, Perth, Western Australia, Australia.
authors.forename: Hannah
authors.initials: H
authors.lastname: Forward
authors.affiliation: School of Population Health, University of Western Australia, Perth, Western Australia, Australia.
authors.forename: Angela
authors.initials: A
authors.lastname: Jacques
authors.affiliation: Department of Anesthesiology, Columbia University College of Physicians and Surgeons, New York, NY.
authors.forename: Caleb
authors.initials: C
authors.lastname: Ing
authors.affiliation: Department of Anesthesia and Pain Management, Princess Margaret Hospital for Children, Perth, Western Australia, Australia; School of Medicine and Pharmacology, The University of Western Australia, Perth, Western Australia, Australia.
authors.forename: Britta S
authors.initials: BS
authors.lastname: von Ungern-Sternberg
authors.affiliation: Center for Ophthalmology and Visual Science, University of Western Australia, Lions Eye Institute, Perth, Western Australia, Australia. Electronic address: David.Mackey@lei.org.au.
authors.forename: David A
authors.initials: DA
authors.lastname: Mackey
mesh_terms: D000293:Adolescent; D000758:Anesthesia / Q000009:adverse effects*; D001315:Australia; D015331:Cohort Studies; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D009216:Myopia / Q000139:chemically induced* / Q000473:pathology; D009412:Nerve Fibers / Q000187:drug effects* / Q000473:pathology; D011247:Pregnancy; D011446:Prospective Studies; D012165:Retinal Ganglion Cells / Q000187:drug effects* / Q000473:pathology; D014792:Visual Acuity / Q000187:drug effects*; D055815:Young Adult