Ocular outcomes in 4-year old prematurely born children.

Przeglad lekarski Pub Date : 2017-01-01
Anna Leśniak, Małgorzata Klimek, Anna Kubatko-Zielińska, Joanna Kobylarz, Magdalena Nitecka, Grażyna Dutkowska, Bożena Romanowska-Dixon, Przemko Kwinta
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Abstract

Purpose: The aim of the study was to assess functional and structural ophthalmologic outcomes in 4-year old very low birth weight children (VLBW).

Material and methods: A group of 82 VLBW children including: (1) children without retinopathy of prematurity – group O (n = 30), (2) children with retinopathy of prematurity with no indications for laser coagulation- group 1 (n = 20 ), (3) children with retinopathy of prematurity treated with laser coagulation – group 2 (n = 32) were enrolled. Functional (visual acuity, visual evoked potentials, stereopsis, color vision test) and structural (anterior eye segment examination and fundoscopy) outcome, cycloplegic refraction, intraocular pressure and angle of squint were examined in all children. Developmental Test of Visual Perception was also assessed.

Results: Very good visual acuity was presented in 56 (68.3%) patients, good visual acuity in 11 (13.4%) children, visual acuity between 0.4 and 0.2 in 13 (15.9%) and unfavorable function (equal or less than 0.1) was observed in 2 (2.4%) children. Twenty-three patients (28.1%) were myopic, 57 patients (69.5%) were hyperopic. Astigmatism > 1D occurred in 49 (59.8%) patients. Anisometropia larger than 2 D occurred in 7 patients (8.7%). There was no statistical difference between frequency of mentioned above complications between the groups. Abnormal VEP results were more common (14 children -54%) in group 2 as compared to other groups (group 0 - 7 children -25%, group 1 – 4 children -24%; p = 0.044). Moreover, the lower percentage of group 2 children presented stereopsis vision (46.9%, group 0 – 93.3%, group 1 – 90%; p<0.05). Children with retinopathy of prematurity treated with laser coagulation had significantly lower Developmental Test of Visual Perceptions scores. In group 1, in 1 child naevus pigmentosus of the eyelid was observed, in group 2 in one child eyeball atrophy in the right eye and aphakia in the left eye were diagnosed. In 1 child in group 0 optic disc drusen were observed, in 2 children optic discs were pale. In 2 children in group 2 retinal detachment stage 5 was diagnosed.

Conclusion: An important factor affecting final ophthalomolgical assessment in prematurely born children is retinopathy of prematurity treated with laser coagulaion. Children with retinopathy of prematurity without laser coagulation had examinations results comparable wih children without retinopathy of prematurity. Diode laser photocoagulation is an effective method of treatment fot active stages of retinopathy of prematurity.

4岁早产儿的眼部预后。
目的:本研究的目的是评估4岁极低出生体重儿(VLBW)的功能和结构的眼科结果。材料与方法:选取82例VLBW患儿,包括:(1)无视网膜病变早产儿O组(n = 30),(2)无激光凝固指征的视网膜病变早产儿1组(n = 20),(3)激光凝固治疗的视网膜病变早产儿2组(n = 32)。检查功能(视力、视觉诱发电位、立体视、色觉)、结构(前眼节检查和眼底镜检查)、睫状体屈光、眼压和斜视角度。对视觉知觉发展测试也进行了评估。结果:56例(68.3%)患儿视力良好,11例(13.4%)患儿视力良好,13例(15.9%)患儿视力在0.4 ~ 0.2之间,2例(2.4%)患儿视力不佳(小于等于0.1)。近视23例(28.1%),远视57例(69.5%)。散光> 1D 49例(59.8%)。屈光参差大于2 D者7例(8.7%)。两组间上述并发症发生频率无统计学差异。与其他组(0 ~ 7组-25%,1 ~ 4组-24%;p = 0.044)。2组儿童立体视发生率较低(46.9%,0 ~ 93.3%,1 ~ 90%;结论:激光凝固治疗早产儿视网膜病变是影响早产儿最终眼科评价的重要因素。未进行激光凝固治疗的早产儿视网膜病变患儿的检查结果与未进行激光凝固治疗的早产儿视网膜病变患儿相当。二极管激光光凝是一种有效的治疗早产儿视网膜病变的方法。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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