Ocular outcomes in 4-year old prematurely born children.

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.