PROSPECTIVE-STUDY OF NEW-ZEALAND INFANTS WITH BIRTH-WEIGHT LESS-THAN 1500 G AND SCREENED FOR RETINOPATHY OF PREMATURITY - VISUAL OUTCOME ATAGE 7-8 YEARS

Aim-To determine the visual outcome at 7-8 years in very low birth wei ght (VLBW: birth weight <1500 g) infants screened for retinopathy of p rematurity (ROP). Methods-In 1986 all 413 VLBW infants admitted to neo natal units in New Zealand were enrolled in a prospective study of acu te ROP. Surviving infants were traced and assessed at a home visit. Vi sual assessment comprised examination for abnormal and range of eye mo vements, visual fields, distance and near visual acuity, stereopsis, a nd photorefraction. Results-Of 338 infants surviving to discharge, 313 (93%) had been examined for acute ROP. ROP was present in 66 (21%: RO P+), absent in 247 (ROP-), with 25 not examined (NA). 298 children (96 % survivors resident in New Zealand: 91% all survivors) were assessed. Any visual problem occurred in 79% ROP+ and 60% ROP-/NA (p<0.01). Dis tance visual acuity less than 4/10 in the worse eye occurred in 29% RO P+ and 15% ROP-/NA (p<0.05); and in the better eye in 19% ROP+ and 5% ROP-/NA (p<0.001). Any myopia in the worse eye occurred in 36% ROP+ an d 18% ROP-/NA (p<0.01); and in the better eye in 25% ROP+ and 11% ROP- /NA (p<0.01). Strabismus, including treated, occurred in 33% ROP+ and 19% ROP-/NA (p<0.05). Overall, 11% had astigmatism and 18% hypermetrop ia with no difference between the groups. Conclusion-In a population b ased study it was confirmed that VLBW is associated with an increased risk of visual problems at school age. A history of ROP is associated with an additional risk of poor outcome, including a near doubling of poor distance acuity, myopia, and strabismus.