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Anastasia Traband, Jennifer Lambert, Stephen P Christiansen; Ocular Comorbidities in Children with Neonatal Abstinence Syndrome. Invest. Ophthalmol. Vis. Sci. 2014;55(13):4093.
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Substance misuse during pregnancy is a significant problem with short- and long-term sequelae to the developing embryo and fetus. Its prevalence is unknown and the incidence of substance misuse during pregnancy is increasing. Neonatal abstinence syndrome is a withdrawal syndrome that occurs in infants exposed to various drugs during pregnancy. There are several case series describing the association between neonatal abstinence syndrome and ocular comorbidities. This study is a retrospective chart review. The purpose is to determine and describe the various ophthalmologic comorbidities found in patients with a history neonatal abstinence syndrome to aid in the establishment of screening guidelines and ophthalmologic surveillance programs.
This study is a retrospective chart review. Subjects were identified by the Clinical Data Warehouse based on inclusion criteria; all children age 6 and under who presented to Boston University Eye Associates for ophthalmologic evaluation between 01/01/2006 and 08/01/2013 with a history of neonatal abstinence syndrome. A list of medical record numbers (MRN) were then provided by the Clinical Data Warehouse for review. Information for this study was collected from paper charts and Logician (Boston Medical Center Electronic Medical Record System). The data points of interest from the subjects' history and ocular examination were extracted including exposure in utero, gestational age at birth, birth weight, visual acuity, refraction, intraocular pressure, binocular alignment, presence of nystagmus, and fundus examination.
Ophthalmic abnormalities described in subjects with a history of neonatal abstinence syndrome included reduced acuity, nystagmus, delayed visual maturation, strabismus, refractive errors, and cerebral visual impairment.
Infants exposed to various drugs of misuse in utero, including methadone, are at risk for developing a range of visual problems. The ocular comorbidities found in this study can have significant implications for visual function and development. Early detection and detailed screening guidelines are essential in successful treatment and optimal visual outcomes in these subjects.
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