Preterm birth and ophthalmological impairments at 5^1/2 years: EPIPAGE-2 cohort study.

Abstract

Purpose : To report prevalence of visual-sensory and oculo-motor impairments at age 5½ among children born preterm.

Methods : Date were extracted from the population based cohort study, EPIPAGE-2 which include preterm born children in France in 2011. At age 5^1/2, 4441 children born at 24-34 Weeks’ Gestation (WG) survivied. We included also a sample of 592 term-born children from the cohort ELFE as reference group. All patients were invited to assess complete medical examination in one of the 110 centers specially opened for the assessment.
We reported prevalence of refractive errors, strabismus, amblyopia, nystagmus and binocular visual acuities. Prevalence are reported after multiple imputation for missing data and sub-group analysis on Cerebral Palsy and history of Retinopathy Of Prematurity were performed.

Results : Among 4441 children, 2718 (weighted-percentage 58.7%) were clinically assessed. Refractive errors were reported in 43.1% (95% confidence interval 37.6-48.4), 35.2% (32.7-37.6) and 28.4% (25.0-31.8) of children born at 24-26, 27-31, 32-34 WG, respectively. Strabismus was reported in respectively 19.5% (14.6-24.4), 14.8% (12.9-16.7), 8.3% (6.2-10.4). Both impairments presented a significant increase of prevalence while GA decrease (p<.001). Among term-born children, refractive errors prevalence was 24.1% (19.1-29.7) and strabismus prevalence was 2.8% (1.0-5.3). Severe/moderate visual deficiencies (<3.2/10) were present in 1.7% (0.2-3.3) of 24-26WG and in less than 1% for other groups. A 10/10 binocular visual acuity was measured for 28.6% (24.0-33.3) of 24-26WG, 35.1% (32.8-37.4) of 27-31WG and 36.0% (32.5-39.5) of 32-34WG Versus 59.7% (53.9-65.4) of reference group. Presence of a Cerebral Palsy at 5^1/2 had a stronger association with visual deficiencies and sub-optimal visual acuity than ROP during neonatal period.

Conclusions : We report in a large cohort of preterm born children high prevalence of refractive errors and strabismus even in children born very and moderate preterm supporting a specific attention for these children. Low prevalence of 10/10 visual acuity, even with glasses, at the age of reading and writing acquisitions could represent an additional challenge.

This abstract was presented at the 2022 ARVO Annual Meeting, held in Denver, CO, May 1-4, 2022, and virtually.