Tracking visual outcomes - Follow-up on patients born preterm with childhood-onset visual impairment.

Abstract

Purpose: Preterm birth is associated with a risk of ocular complications. The primary aim of the study was to evaluate the main cause of visual impairment (VI) in a cohort of preterm born patients who had childhood-onset VI. The association between health-related quality of life (HRQoL) and age, cause-and severity of VI and impairment type was assessed.

Methods: In Denmark, patients <18 years with VI are enrolled at the National Danish Registry of Children with Visual Impairment (NDRCVI). Patients born preterm and enrolled at NDRCVI at any time between 1988 and 2020 were invited for a follow-up regardless of current age. Examinations performed were visual acuity (VA), refraction, Goldmann visual fields, ocular biometry and posterior segment imaging. The three main outcomes were VA sorted by VI severity (mild, moderate, severe and blind), a score for HRQoL (HUI3) and the main cause of VI.

Results: Thirty-two preterm-born patients participated in the study with a median age of 28 years at examination (range 8-43). ROP was the main cause of VI in 15 patients (47%) followed by CVI in eight patients (25%). Increasing age at assessment had a significantly negative impact on the HRQoL-score, when unadjusted for type of impairments. HRQoL was significantly lower in patients with combined impairments compared to isolated VI (p = 0.003).

Conclusion: ROP and CVI were the most common causes of VI. The HRQoL was significantly lower when VI was combined with other impairments in contrast to isolated VI. Reducing cerebral damage in preterm born children is likely to enhance both HRQoL and visual function.