July 2018
Volume 59, Issue 9
Open Access
ARVO Annual Meeting Abstract  |   July 2018
The effect of neonatal hyperglycaemia on visual acuity and ocular biometry in children born very preterm
Author Affiliations & Notes
  • Myra Leung
    School of Optometry and Vision Science, University of Auckland, Auckland, New Zealand
    Department of Paediatrics: Child and Youth Health, University of Auckland, Auckland, New Zealand
  • Tanya Poppe
    School of Optometry and Vision Science, University of Auckland, Auckland, New Zealand
  • Anna Tottman
    Liggins Institute, University of Auckland, Auckland, New Zealand
  • Ben Thompson
    School of Optometry and Vision Science, University of Waterloo, Ontario, Ontario, Canada
  • Joanna Black
    School of Optometry and Vision Science, University of Auckland, Auckland, New Zealand
  • Jane Harding
    Liggins Institute, University of Auckland, Auckland, New Zealand
  • Frank Bloomfield
    Liggins Institute, University of Auckland, Auckland, New Zealand
  • Jane Alsweiler
    Department of Paediatrics: Child and Youth Health, University of Auckland, Auckland, New Zealand
  • Footnotes
    Commercial Relationships   Myra Leung, None; Tanya Poppe, None; Anna Tottman, None; Ben Thompson, None; Joanna Black, None; Jane Harding, None; Frank Bloomfield, None; Jane Alsweiler, None
  • Footnotes
    Support  The Health Research Council of New Zealand (grant no. 12-095), University of Auckland Doctoral Scholarship, New Zealand Association of Optometry Postgraduate Scholarship
Investigative Ophthalmology & Visual Science July 2018, Vol.59, 2144. doi:
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      Myra Leung, Tanya Poppe, Anna Tottman, Ben Thompson, Joanna Black, Jane Harding, Frank Bloomfield, Jane Alsweiler; The effect of neonatal hyperglycaemia on visual acuity and ocular biometry in children born very preterm. Invest. Ophthalmol. Vis. Sci. 2018;59(9):2144.

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      © ARVO (1962-2015); The Authors (2016-present)

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Abstract

Purpose : Children born very preterm (< 32 weeks' gestational age) are at risk of neonatal hyperglycaemia, impaired vision and abnormal ocular development. We investigated the relationship between neonatal hyperglycaemia, visual acuity (VA) and ocular biometry in seven-year old children born very preterm.

Methods : Children born at < 30 weeks’ gestational age (GA) or < 1500g birth weight (BW) with neonatal hyperglycaemia (two consecutive blood glucose concentrations (BGC) > 8.5 mmol.L-1 at least 4 hours apart) (cases) were matched with controls without neonatal hyperglycaemia by sex, GA, BW, date of birth, socio-economic status and multiple birth. Visual acuity (VA) was measured using a Keeler Crowded logMAR chart. Ocular biometry including corneal thickness, anterior chamber depth, axial length, lens thickness and corneal curvature was measured using a Lenstar LS900 Non-contact Biometer (Haag-Streit Diagnostics, Japan). Data are summarised in median (IQR) or mean ± SD. Outcomes were compared between groups using linear regression. Results are presented as unstandardised coefficient (β) and 95% confidence interval (CI).

Results : 111 children were assessed at 7.2 ± 0.1 years of age (57 cases, 54 controls: GA 25 (25 - 27) vs 26 (26 - 28) weeks; BW: 790 (700 - 863) vs 988 (879 - 1130) g). VA in the better eye did not differ between groups (0.00 ± 0.16 v -0.04 ± 0.12 logMAR, p = 0.18) but binocular VA was poorer in cases (0.00 ± 0.16 vs -0.09 ± 0.11 logMAR, p = 0.03). In the eye with better VA, cases had a thicker lens (3.83 ± 0.27 v 3.69 ± 0.22 mm, p = 0.03). Other biometry measurements did not differ between the groups. Mean lens thickness increased by 0.10 mm (95% CI 0.05 - 0.15, p < 0.0001) per 1 mmol.L-1 increase in mean BGC in the first month after birth. Mean visual acuity increased by 0.25 logMAR (95% CI 0.16 - 0.34, p < 0.0001) per 1 mm increase in lens thickness.

Conclusions : Neonatal hyperglycaemia was associated with increased lens thickness at 7 years of age. This increased lens thickness is similar to that found in long-standing adult type I and II diabetes mellitus, suggesting that transient increases in BGC may have long-term effects on ocular growth and visual acuity.

This is an abstract that was submitted for the 2018 ARVO Annual Meeting, held in Honolulu, Hawaii, April 29 - May 3, 2018.

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