Prevalence of strabismus, nystagmus and risk factors in children and adolescents born preterm with and without retinopathy of prematurity: results from the Gutenberg Prematurity Study Young

Aims This study assessed the prevalence of strabismus, nystagmus and their risk factors in children born preterm, stratified by gestational age (GA), retinopathy of prematurity (ROP) and ROP treatment. Methods This is a retrospective cohort study with a prospective follow-up in a large cohort of children born preterm and full-term aged 4–17 years. Multivariable logistic regression analyses assessed associations of strabismus and nystagmus with perinatal parameters. Participants were divided into the following groups: controls born at term (GA ≥37 weeks, group 1), children born preterm without ROP and GA 33–36 weeks (group 2), GA 29–32 weeks (group 3), GA ≤28 weeks (group 4), GA ≤32 weeks with untreated ROP (group 5) and GA ≤32 weeks with treated ROP (group 6). Results 949 children (11.21±3.92 years, 495 females) were included. Strabismus was observed in 6% of children in group 1, 10% in group 2, 12% in group 3, 23% in group 4, 20% in group 5 and 68% in group 6. Nystagmus was observed in 0.8%, 0.4%, 1.8%, 2.6%, 5.0% and 47% in the respective groups. Strabismus was associated with earlier GA (OR=1.08; p=0.01), astigmatism (OR=2.48; p=0.02) and hypermetropia (OR=2.09; p=0.04). Esotropia was associated with weeks of prematurity (OR=1.11; p=0.02), anisometropia (OR=3.09; p=0.02) and hypermetropia (OR=4.17; p<0.001). Nystagmus was associated with ROP (OR=7.49; p=0.03), anisometropia (OR=5.17; p=0.04) and myopia (OR=11.09; p<0.001). Conclusions Strabismus in children is linked to preterm birth and refractive error, while nystagmus is more prevalent in children with ROP and children with refractive errors. Data are available upon reasonable request. AF had full access to all study data and takes responsibility for the integrity of the data and the accuracy of the data analysis. Statistical analyses were performed by AF and SaG. The analysis presents clinical data of a cohort. This project constitutes a major scientific effort with high methodological standards and detailed guidelines for analysis and publication to ensure scientific analyses are on the highest level. Therefore, data are not made available for the scientific community outside the established and controlled workflows and algorithms. To meet the general idea of verification and reproducibility of scientific findings, we offer access to data at the local database upon request at any time. Interested researchers may make their requests to the coordinating principal investigator of the GPES (Achim Fieß; achim.fiess{at}unimedizin-mainz.de). More detailed contact information is available at the homepages of the University Medical Center Mainz (www.unimedizin-mainz.de).