Abstract
Purpose:
Patients who had ROP are at increased risk for developing refractive errors and strabismus, but targeted earlier vision screening has not been implemented. The prevalence of amblyogenic risk factors (ARFs) in patients not eligible for ROP screening is less understood. The purpose of this retrospective chart review of a prospective cohort is to investigate whether earlier or targeted vision screening is necessary in patients with a history of prematurity.
Methods:
Retrospective chart review of a prospective cohort of premature babies (gestational age <37 weeks) born between 10/2009-10/2011. All patients had an outpatient ophthalmologic examination scheduled at 6 months of life prior to discharge and then followed every 6 months until 36 months of age. The main outcome was presence of ARF as defined by AAPOS and AAO guidelines. Other variables including intrauterine growth retardation (IUGR), family history, drug exposure and CNS comorbidities were also studied.
Results:
113 patients met inclusion criteria; 57% were Hispanic. For the patients who received ROP screening, the mean birth weight (BW) was 1477 grams and GA was 30.2 weeks. For the non-ROP screened, the mean GA was 35.3 and BW was 2547 grams. The proportion of patients with ARF at any given visit ranged from 13-22% among the ROP-screened and 8-19% among the non-ROP screened. The compliance with follow-up decreased from 50 to 30% and 85 to 25% in the ROP and non-ROP screened groups, respectively.
Conclusions:
Earlier vision screening should be considered in this high-risk population. Compliance with comprehensive eye examination decreases significantly over time therefore other strategies for the identification of these patients should be favored.