Children born weighing less han 1701g: Visual outcome and cognitive outcome at 11 to 14 years
- Terence Stephenson (terence.stephenson{at}nottingham.ac.uk)
- Ann Johnson (ann.johnson{at}perinatal-epidemiology.oxford.ac.uk)
Abstract
Background:In low birthweight children, few studies have explored the relationship between later visual morbidity and neuropsychological function. We have evaluated these outcomes using a geographically defined cohort.
Methods:A prospective study of retinopathy of prematurity (ROP) in infants born < 1701g was undertaken between 1985 and 1987. 254 of the survivors consented to ophthalmic examination at 10-13 years of age. Four children were severely disabled and could not complete the tests. Of the 250 remaining, 198 agreed to neuropsychological assessment one year later at 11-14 years (British Ability Scales II (BAS), Movement Assessment Battery (ABC), Neale Analysis of Reading Ability).
Results:At 10-13 years, 99 of 198 had an adverse ophthalmic outcome (AOO) (reduced acuity n=48, myopia n=40, strabismus n=36, colour defect n=2, field defect n=1). Children with AOO were not significantly different from those with a normal ophthalmic outcome in sex, gestation, birthweight, neonatal cranial scan appearances or social class. 106 of 198 had suffered ROP. 98 had mild ROP and there was no increased risk of AOO in later childhood. All 8 children with severe ROP had an AOO in later childhood. Children with an AOO performed worse on BAS, ABC and reading ability.
Conclusions:At age 10-13, 50% of children born <1701g have an AOO. These children are not simply those with earlier gestations, lower birthweight or those who had ROP. Children with AOO have a worse neuropsychological outcome. The next step is to determine whether there are visual interventions which can improve ophthalmic outcome and whether a better neuropsychological outcome follows.
