Vision-related quality of life in children with treated retinopathy of prematurity.

Purpose: To evaluate vision-related quality of life in children treated for retinopathy of prematurity. Methods: Cross sectional observational study of 54 treated ROP babies 2-7 years of age. The study excluded babies with chronic pediatric conditions and babies of parents suffering from mental illness. Detailed examination including visual acuity was done for all. Two versions of CVFQ questionnaire for children under 3 and above 3 years of age were posed to parents in this study. CVFQ contains six subscales: General health, vision health, competence, personality, family impact, and treatment difficulty. The scores ranged from 0 (worst score) to 1 (best score). Results: The study included 54 children with mean birth weight was 1194 grams, mean gestation age 30 weeks. The age, gender, birth weight, and gestational age didn't affect the overall quality of life (P > 0.05). The severity of ROP (stage 4 and 5) had poorer CVFQ scores (personality and family impact subscales). Competence and personality scores were significantly lower in zone I disease. The quality of life especially general vision, competence, personality, and treatment difficulty subscales had significantly lower values in ROP with higher clock hour involvement (P < 0.05). With myopia after ROP treatment, only personality subscale was significantly affected (P 0.02). Mean CVFQ score including the family impact and treatment difficulty subscale score was also significantly lower in amblyopic and anisometropic children (P value < 0.05). Family impact subscale and overall quality of life was significantly lower in children with strabismus than children without strabismus (P 0.001). Conclusion: ROP has negative effect on the vision-related quality of life of children and their parents. The overall quality of life worsened with the increase in the severity of disease and the occurrence of ocular sequelae of ROP. The vision of the baby may not be the only cause of low scores in the quality of life questionnaire in ROP.

A modified developmental care bundle reduces pain and stress in preterm infants undergoing examinations for retinopathy of prematurity: A randomised controlled trial.

AIMS AND OBJECTIVES: To determine the comparative efficacy of developmental care versus standard care for reducing pain and stress in preterm infants during examinations for retinopathy of prematurity (ROP). BACKGROUND: ROP examinations are routinely performed in neonatal intensive care units to detect these lesions. Pain scores recorded during and after eye examinations have revealed physiological and behavioural manifestations of pain and stress. DESIGN: A randomised crossover trial was conducted. METHODS: Fourteen preterm infants were evaluated. The modified developmental care bundle included environmental modifications, positioning and containment, oxygen supplementation, interaction and approach and cue-based individual care, which were applied before, during and after the ROP examination. The primary outcomes were obtained from pain and stress scores using the premature infant pain profile-revised (PIPP-R) and a behavioural evaluation. The secondary outcomes were recovery time to the baseline of the vital signs and oxygen saturation. RESULTS: Statistical significances were found in the care type comparison (p = 0.013), time comparison (p < 0.001) and type-by-time interaction (p = 0.005) in the PIPP-R, and also in the care type comparison (p < 0.001), time comparison (p < 0.001) and type-by-time interaction (p = 0.001) in the behavioural evaluation scores using a generalised estimating equation (GEE) analysis. Recovery time for the developmental care (N = 13, mean = 8.6 ± 11.5 min, 95% CI = 1.68-15.57) was significantly shorter than for the standard care (N = 11, mean = 25.5 ± 20.8 min, 95% CI = 11.45-39.46), which was found to be statistically significant according to the Wilcoxon signed-rank test (N = 11, p = 0.003). CONCLUSIONS: A bundled developmental care intervention significantly reduced pain and stress responses and the time needed for infants to recover their physiological status following the procedure. RELEVANCE TO CLINICAL PRACTICE: Since the results show the benefits of developmental care in an ROP examination, it can be the practical evidence basis by which to develop a standard of procedure or guideline for clinical practice.

Awareness of retinopathy of prematurity among pediatricians in West Bank, Palestine: a descriptive study.

BACKGROUND: Retinopathy of prematurity (ROP) is a disorder of the developing retina of preterm infants due to defective vasculogenesis. The aim of the study was to analyze the level of awareness, knowledge, attitude and practice of pediatricians about ROP in the West Bank, Palestine. METHODS: A questionnaire was designed on the knowledge, attitude, and practice (KAP) pattern. The questionnaire included questions about pediatrician's educational and practicing profile, knowledge of screening guidelines, risk factors for ROP, referral facilities and barriers for referral. The questionnaire was given to70 practicing specialists and residents in hospitals having neonatal intensive care units in the West Bank, Palestine. It was a self-administered questionnaire, collected between November 2016 and February 2017. RESULTS: A total of 70 pediatricians from 11 different hospitals without ROP screening service participated in the study. The mean age of the participants was 33.04 ± 7.74. Of which, 62.9% were males and 37.1% were females. Fifty-nine (84.3%) answered that ROP is preventable, while 11 (15.7%) responded that ROP is not preventable. Nine (12.9%) pediatricians had no idea as to which part of the eye is affected in ROP. Among the participants, 29 (41.4%) did not know when ROP screening should be started. Sixty-three (90%) pediatricians were sure that ROP is treatable. Regarding barriers for ROP screening, 'ophthalmologist not available' reason was expressed by 37.1% (26/70), 'discharge person not writing' by 20% (14/70) and 'parents not agreeing' by 18.6% (13/70) of the participants. Knowledge on the use of laser as a treatment modality of ROP was shown by 39 (55.7%) participants, and the use of anti-VEGF was shown by 6 (8.6%) participants, whereas 25 (35.7%) of the participants didn't know about the treatment modalities. CONCLUSION: The study findings suggest that a large majority of pediatricians were aware of ROP as a preventable disease, but had less information about ROP screening guidelines and service delivery. The study suggests the need to increase the awareness of pediatricians by dissemination of information about ROP and creating a close coordination between them and ophthalmologists to address barriers for service delivery in Palestine.

Parents' Knowledge and Education of Retinopathy of Prematurity in Four California Neonatal Intensive Care Units.

PURPOSE: Retinopathy of prematurity (ROP) may cause visual impairment in infants with very low birth weight. Lack of parent knowledge may contribute to gaps in screening and treatment. We studied parents' knowledge and education of ROP. DESIGN: Cross-sectional study. METHODS: Setting: Four high-acuity neonatal intensive care units in California (40-84 beds). PARTICIPANTS: Total of 194 English- and Spanish-speaking parents of very low birth weight (<1500 grams) infants recruited from September 2013 to April 2015. MAIN OUTCOME MEASURES: We asked parents what they knew about ROP, how they were educated about ROP, and their experiences obtaining outpatient eye care. We used multivariate analysis to assess whether parent knowledge was associated with level of English proficiency and literacy, education modality (verbal, written, online, video), and hospital transfer status. RESULTS: Of the 194 participants, 131 (68%) completed surveys: 18% had both limited English proficiency and low literacy while overall 26% had limited English proficiency and 37% had low literacy; 17% did not know that ROP is an eye disease, and 38% did not know that very low birth weight and prematurity are both risk factors for ROP. Parents reported receiving verbal (62%) or written (56%) information; few used online resources (12%) or videos (3%). Half reported receiving information about infants' retinopathy status at discharge. No education modality was associated with higher knowledge. Limited English proficiency and low literacy were associated with lower knowledge (vs English-proficient, literate). CONCLUSIONS: Parents of infants with very low birth weight, particularly those with limited English proficiency and low health literacy, lack knowledge about ROP.

Evaluation of maternal attachment, self-efficacy, levels of depression, and anxiety in mothers who have babies diagnosed with retinopathy of prematurity.

PURPOSE: The aim of this study is to evaluate the emotional stress and its effects on parental self-efficacy and mother-infant attachment in mothers whose babies were diagnosed with retinopathy of prematurity (ROP). METHODS: Study sample was consisted of voluntarily participating 82 mothers whose babies were first diagnosed with ROP, 83 mothers of preterm babies without ROP, and 85 mothers of term babies admitting for their routine visits. Sociodemographic data form maternal attachment scale, state-trait anxiety inventory, Edinburgh postnatal depression scale, and parental self-efficacy scale were applied to study participants, and the overall results of three groups were statistically compared. RESULTS: The sociodemographic features of three study groups were similar. Statistical significant differences were found in depression and state anxiety levels among study groups, while maternal attachment scale and trait anxiety level scores and parental self-efficacy scale total score were similar in study groups. Maternal depression and state-anxiety levels were tend to be higher in mother of children diagnosed with ROP and prematurity; however, there were no statistically significant differences between levels of mothers' of premature children with or without ROP. CONCLUSION: This is the first study in literature assessing the additional effect of ROP on the anxiety and depression levels of recent mothers, as well as mother-infant attachment and parental self-efficacy. Supporting of mothers having an infant with diagnosed ROP is crucial because of feeling themselves inefficient and responsible for all interventions applied to their babies.

Motion Perception and Form Discrimination in Extremely Preterm School-Aged Children.

This population-based study evaluated motion and form perception in 71 children born extreme premature (EPT; < 27 gestational weeks), aged 6.5 years, as compared to a matched group of 79 control children born at term. Motion and form perception were evaluated by motion coherence and form coherence tests. The EPT group showed a poorer performance on both tasks as compared to the control group. However, after controlling for IQ and visual acuity, the EPT group showed only a significant deficit in motion perception. No association was found between motion perception accuracy and gestational age, previous retinopathy of prematurity, or previous intraventricular hemorrhage in the EPT group. The results highlight the long-term motion perception deficits in children born EPT.

Temperament and behavior in toddlers born preterm with related clinical problems.

OBJECTIVE: The aim of this study was to compare temperament and behavior profiles among groups of preterm toddlers differentiated by level of prematurity and the presence of bronchopulmonary dysplasia (BPD) or retinopathy of prematurity (ROP), controlling for neonatal clinical conditions and chronological age. METHOD: The sample comprised 100 preterm toddlers segregated according to level of prematurity (75 very preterm and 25 moderate/late preterm) and presence of BPD (n=36) and ROP (n=63). Temperament was assessed by the Early Childhood Behavior Questionnaire and behavior by the Child Behavior Checklist. The MANOVA was performed with a post-hoc univariate test. RESULTS: The level of prematurity and the presence of BPD and ROP did not affect temperament and behavioral problems in toddlers born preterm. However, the covariates age and length of stay in NICU (Neonatal Intensive Care Unit) affected temperament and behavioral problems, respectively. The older toddlers showed higher inhibitory control and lower activity levels than younger toddlers (range of 18-36months-old). Additionally, toddlers who stayed in the NICU longer showed more pervasive development and emotionally reactive problems than toddlers who stayed in NICU for less time. CONCLUSION: The level of prematurity and the presence of bronchopulmonary dysplasia and retinopathy of prematurity did not affect temperament and behavioral problems in toddlers born preterm. However, a longer stay in the NICU increased the risk for behavioral problems, and age enhanced the regulation of temperament at toddlerhood.

Ophthalmologic Outcomes of Children Born Premature Without ROP: Correlations With Gestational Age and Psychomotor Development.

PURPOSE: To study ophthalmological outcomes of premature children with no retinopathy of prematurity (ROP) and correlate with neurodevelopmental outcomes. METHODS: A total of 69 former preterm infants were evaluated at 2 to 7 years of age. Detailed ophthalmologic examinations were performed. Neurodevelopment was assessed using the Peabody Developmental Motor Scale and Wechsler Preschool and Primary Scale of Intelligence. Another 69 healthy children served as controls. RESULTS: The 69 preterm children (38 of 69 boys) and 69 controls (38 of 69 boys) had a mean age of 4.9 ± 1.5 and 4.9 ± 1.4 years, respectively. Compared to controls, preterm infants had vision impairment of 19% versus 1.4% (P = .001), hyperopia of 87% versus 98.5% (P = .21), myopia of 11% versus 1.4% (P = .017), and astigmatism of 39% versus 30.4% (P = .37). Children with any motor disability tended to have worse vision. CONCLUSIONS: In the absence of ROP, hyperopia was more common in infants 32 weeks or older who weighed more than 1,500 g at birth; other vision problems were similar in subgroups. This may represent impending myopia in those younger than 32 weeks weighing less than 1,500 g. [J Pediatr Ophthalmol Strabismus. 2017;54(1):32-38.].

Allocentric Spatial Performance Higher in Early-Blind and Sighted Adults Than in Retinopathy-of-Prematurity Adults.

The question as to whether people totally blind since infancy process allocentric or external spatial information like the sighted has caused considerable debate within the literature. Due to the extreme rarity of the population, researchers have often included individuals with retinopathy of prematurity (RoP--over oxygenation at birth) within the sample. However, RoP is inextricably confounded with prematurity per se. Prematurity, without visual disability, has been associated with spatial processing difficulties. In this experiment, blindfolded sighted participants and two groups of functionally totally blind participants heard text descriptions from a survey (allocentric) or route (egocentric) perspective. One blind group lost their sight due to RoP and a second group before 24 months of age. The accuracy of participants' mental representations derived from the text descriptions was assessed via questions and maps. The RoP participants had lower scores than the sighted and early blind, who performed similarly. In other words, it was not visual impairment alone that resulted in impaired allocentric spatial performance in this task but visual impairment together with RoP. This finding may help explain the contradictions within the existing literature on the role of vision in allocentric spatial processing.

Vision-related quality of life in children with retinopathy of prematurity.

PURPOSE: To evaluate the effect of retinopathy of prematurity (ROP) on vision-related quality of life in children. METHODS: The Children's Visual Function Questionnaire (CVFQ), an instrument that evaluates vision-related quality of life in children, was used. It is divided into 6 subscales: General Health, Vision Health, Competence, Personality, Family Impact, and Treatment. The sample consisted of parents of premature children up to 3 years of age who had ROP and no neurological damage (ROP group) and parents of premature children up to 3 years of age who had normal vision and absence of other diseases (control group). RESULTS: There were 88 subjects in total, 43 in the ROP group and 45 in the control group. The ROP group had lower scores on the CVFQ than the control group. The Total Index and all CVFQ subscale scores and for were significant lower in the ROP group than in the control group. The ROP group was divided according to the severity of the disease. The Total Index, Vision Health, and Competence scores in children with more severe ROP were significantly lower than those in children with less severe ROP. CONCLUSION: ROP was shown to have a negative effect on vision-related quality of life in children.

Vision-related quality of life in children with retinopathy of prematurity / Qualidade de vida relacionada à visão em crianças com retinopatia da prematuridade

ABSTRACTPurpose:To evaluate the effect of retinopathy of prematurity (ROP) on vision-related quality of life in children.Methods:The Children's Visual Function Questionnaire (CVFQ), an instrument that evaluates vision-related quality of life in children, was used. It is divided into 6 subscales: General Health, Vision Health, Competence, Personality, Family Impact, and Treatment. The sample consisted of parents of premature children up to 3 years of age who had ROP and no neurological damage (ROP group) and parents of premature children up to 3 years of age who had normal vision and absence of other diseases (control group).Results:There were 88 subjects in total, 43 in the ROP group and 45 in the control group. The ROP group had lower scores on the CVFQ than the control group. The Total Index and all CVFQ subscale scores and for were significant lower in the ROP group than in the control group. The ROP group was divided according to the severity of the disease. The Total Index, Vision Health, and Competence scores in children with more severe ROP were significantly lower than those in children with less severe ROP.Conclusion:ROP was shown to have a negative effect on vision-related quality of life in children.

RESUMOObjetivo:Avaliar a influência da retinopatia da prematuridade (ROP) na qualidade de vida relacionada à visão em crianças.Método:Utilizou-se o Questionário de Função Visual Infantil - (QFVI), - um instrumento de qualidade de vida relacionada à visão em crianças, dividido em seis subescalas: Saúde Geral, Saúde da Visão, Competência, Personalidade, Impacto Familiar e Tratamento. A amostra foi constituída por pais de crianças prematuras, de até três anos de idade, com diagnóstico de ROP e ausência de sequelas neurológicas (grupo ROP) e pais de crianças de até três anos de idade, prematuras, com visão normal (grupo controle) e ausência de outras doenças associadas.Resultados:Participaram da pesquisa 88 indivíduos, 43 no grupo ROP e 45 no grupo controle. Houve redução estatisticamente significante do grupo ROP em comparação ao grupo controle em todas as subscalas do QFVI e Índice Geral. O grupo ROP foi dividido segundo a gravidade da doença. As crianças com ROP mais grave apresentaram notas inferiores e redução estatisticamente significante em comparação ao grupo de ROP menos grave no Índice Geral e nos domínios Saúde da Visão e Competência.Conclusão:A ROP apresenta impacto negativo na qualidade de vida relacionada à visão em crianças.

[Modern perspective on the problem of retinopathy of prematurity].

The article contains an analysis of the current state of the problem of retinopathy of prematurity (RP). Advances of international and Russian ophthalmology in understanding the pathogenesis, clinical presentation of both active and regressive RP, results of multicentre studies on RP treatment and prognosis were taken into consideration. There is a tendency towards a considerable change in the range of survived premature newborns and a growing need for development of new treatment approaches on the basis of pathogenetic studies. A wide range of RP outcomes, late complications, and concomitant pathology, which determine functional prognosis and quality of life in patients who have had RP, is discussed.

" Um sonho cortado pela metade... ": estudo de caso sobre o impacto da prematuridade e da deficiência visual do bebê na parentalidade / " A dream cut in half... ": A case study of the impact of prematurity and the vision impairment of the babyon parenthood / " Un sueño cortado al medio... ": Estudio de caso sobre el impacto de la prematuridad y de la discapacidadvisual del bebé en la parentalidad

Quando a prematuridade culmina com um diagnóstico de retinopatia da prematuridade com perda da visão, os pais sofrem um duplo impacto. O presente estudo teve por objetivo investigar as reações emocionais dos pais nesse contexto e seu impacto na parentalidade. Para tanto, pais de uma menina de 13 meses foram entrevistados conjuntamente. Os dados foram examinados, utilizando-se a análise de conteúdo. Os resultados mostraram um choque dos pais com a aparência do bebê prematuro, o medo da morte do bebê, dificuldades para a compreensão do diagnóstico, negação, culpa, sentimentos hostis em relação à equipe médica e diminuição da autoeficácia do casal como pais. Por outro lado, identificou-se uma busca de reorganização do casal e alegrias frente à parentalidade.(AU)

Prematurity in conjuction with diagnosis of premature retinopathy aimed to with loss of vision cause, in parents a double impact. This study aimed to investigate the emotional parents reactions in this context and its impact on parenthood. Parents of a 13 months old baby girl were interviewed together. The data was examined by means of content analysis. The results revealed that parents were in shock with the appearance of the premature baby, faced fear of the baby's death, difficulty to understand the diagnosis, denial, guilt, hostile sentiments toward the medical team and diminished self-efficacy as parents. On the other hand, a couple's reorganization and happiness in the face of parentality, were also identified.(AU)

Cuando la prematuridad culmina con un diagnóstico de la retinopatía, con pérdida de la visión, los padres sufren un doble impacto. El presente estudio tuvo como objetivo investigar las reacciones emocionales de los padres en este contexto y su impacto en la parentalidad. Para ello, se entrevistó conjuntamente a los padres de una niña de 13 meses. Los datos fueron analizados mediante análisis de contenido. Los resultados mostraron un choque de los padres con la aparencia de un bebé prematuro, miedo de la muerte del bebé, dificultades para comprender el diagnóstico, negación, culpa, sentimientos de hostilidad hacia el equipo médico y la disminucíon de la auto-eficacia de la pareja como padres. Por otra parte, fue identificada una búsqueda de reorganización de la pareja y de alegrías por la parentalidad.(AU)

" Um sonho cortado pela metade... ": estudo de caso sobre o impacto da prematuridade e da deficiência visual do bebê na parentalidade / " A dream cut in half... ": A case study of the impact of prematurity and the vision impairment of the babyon parenthood / " Un sueño cortado al medio... ": Estudio de caso sobre el impacto de la prematuridad y de la discapacidadvisual del bebé en la parentalidad

Quando a prematuridade culmina com um diagnóstico de retinopatia da prematuridade com perda da visão, os pais sofrem um duplo impacto. O presente estudo teve por objetivo investigar as reações emocionais dos pais nesse contexto e seu impacto na parentalidade. Para tanto, pais de uma menina de 13 meses foram entrevistados conjuntamente. Os dados foram examinados, utilizando-se a análise de conteúdo. Os resultados mostraram um choque dos pais com a aparência do bebê prematuro, o medo da morte do bebê, dificuldades para a compreensão do diagnóstico, negação, culpa, sentimentos hostis em relação à equipe médica e diminuição da autoeficácia do casal como pais. Por outro lado, identificou-se uma busca de reorganização do casal e alegrias frente à parentalidade...

Prematurity in conjuction with diagnosis of premature retinopathy aimed to with loss of vision cause, in parents a double impact. This study aimed to investigate the emotional parents reactions in this context and its impact on parenthood. Parents of a 13 months old baby girl were interviewed together. The data was examined by means of content analysis. The results revealed that parents were in shock with the appearance of the premature baby, faced fear of the baby's death, difficulty to understand the diagnosis, denial, guilt, hostile sentiments toward the medical team and diminished self-efficacy as parents. On the other hand, a couple's reorganization and happiness in the face of parentality, were also identified...

Cuando la prematuridad culmina con un diagnóstico de la retinopatía, con pérdida de la visión, los padres sufren un doble impacto. El presente estudio tuvo como objetivo investigar las reacciones emocionales de los padres en este contexto y su impacto en la parentalidad. Para ello, se entrevistó conjuntamente a los padres de una niña de 13 meses. Los datos fueron analizados mediante análisis de contenido. Los resultados mostraron un choque de los padres con la aparencia de un bebé prematuro, miedo de la muerte del bebé, dificultades para comprender el diagnóstico, negación, culpa, sentimientos de hostilidad hacia el equipo médico y la disminucíon de la auto-eficacia de la pareja como padres. Por otra parte, fue identificada una búsqueda de reorganización de la pareja y de alegrías por la parentalidad...

Long-term effects of retinopathy of prematurity (ROP) on rod and rod-driven function.

The purpose of this study was to determine whether recovery of scotopic sensitivity occurs in human ROP, as it does in the rat models of ROP. Following a cross-sectional design, scotopic electroretinographic (ERG) responses to full-field stimuli were recorded from 85 subjects with a history of preterm birth. In 39 of these subjects, dark adapted visual threshold was also measured. Subjects were tested post-term as infants (median age 2.5 months) or at older ages (median age 10.5 years) and stratified by severity of ROP: severe, mild, or none. Rod photoreceptor sensitivity, S (ROD), was derived from the a-wave, and post-receptor sensitivity, log σ, was calculated from the b-wave stimulus-response function. Dark adapted visual threshold was measured using a forced-choice preferential procedure. For S (ROD), the deficit from normal for age varied significantly with ROP severity but not with age group. For log σ, in mild ROP, the deficit was smaller in older subjects than in infants, while in severe ROP, the deficit was quite large in both age groups. In subjects who never had ROP, S (ROD) and log σ in both age groups were similar to those in term born controls. Deficits in dark adapted threshold and log σ were correlated in mild but not in severe ROP. The data are evidence that sensitivity of the post-receptor retina improves in those with a history of mild ROP. We speculate that beneficial reorganization of the post-receptor neural circuitry occurs in mild but not in severe ROP.

Long term functional and structural outcomes of laser therapy for retinopathy of prematurity.

AIMS: To assess the long term functional and structural outcomes of premature babies who received diode laser photocoagulation for threshold retinopathy of prematurity (ROP). METHODS: 25 patients (43 eyes) treated with laser were recalled for assessment at a mean follow up of 11 years. A further seven patients (14 eyes) with subthreshold ROP, which had regressed spontaneously without laser treatment, were also examined. All children underwent distance acuity, near acuity, contrast sensitivity (CS), and colour vision assessments followed by a dilated fundal examination and cycloplegic autorefraction. RESULTS: The laser treated eyes had a mean distance visual acuity of 0.37 logMAR, a mean near visual acuity of 0.39 logMAR, a mean contrast sensitivity of 1.49 log CS units, and a mean spherical equivalent of -2.10D. An unfavourable distance visual acuity outcome occurred in five eyes (13.5%). An unfavourable near visual acuity outcome was also noted in the five eyes (13.5%) with poor distance visual outcome. 7% had an unfavourable structural outcome. On comparison with the control group, there was no significant difference in near acuity, CS, refraction, or colour vision between the two groups. However, there was a statistically significant difference in terms of distance visual acuity (p = 0.03). CONCLUSIONS: Laser treated eyes with favourable structural outcome have a good visual outcome. The results show a long term benefit from diode laser photocoagulation in preserving distance and near vision in eyes with threshold ROP.

Contrast sensitivity in 10 year old preterm and full term children: a population based study.

AIMS: To determine the contrast sensitivity (CS) in 10 year old prematurely born children, previously included in a population based study on the incidence of retinopathy of prematurity (ROP), and in full term controls. METHODS: This study included 205 prematurely born children and 215 children born at term, from the same geographical area and study period. CS was assessed monocularly with the Vistech 6500 test at five spatial frequencies (1.5-18 cycles/deg). RESULTS: Prematurely born children had statistically significant lower CS at all frequencies, compared to full term ones. The mean differences in logarithmic CS were 0.03 (1.5 cycles/deg), 0.09 (3 cycles/deg), 0.10 (6 cycles/deg), 0.12 (12 cycles/deg), and 0.19 (18 cycles/deg). Even when the children with ROP and neurological disorders were excluded there was a difference between the two groups. Children who had been treated with cryotherapy had the lowest CS. CONCLUSION: CS was lower in 10 year old prematurely born children than in full term ones of the same age. Whether this finding affects their visual function in daily life is uncertain.

Health-related quality of life at age 10 years in very low-birth-weight children with and without threshold retinopathy of prematurity.

OBJECTIVE: To describe parental perspectives on health status and health-related quality of life (HRQL) at age 10 years in children with birth weights less than 1251 g who participated in the multicenter Cryotherapy for Retinopathy of Prematurity (CRYO-ROP) study. METHODS: In 244 participants in the randomized CRYO-ROP trial and 102 CRYO-ROP participants who did not develop ROP, the Health Utilities Index (HUI) system was used to characterize health status for the following 8 attributes: vision, hearing, speech, ambulation, dexterity, emotion, cognition, and pain. Using a utility formula, HRQL was determined for each child on a scale from 0.0 (dead) to 1.00 (perfect health). RESULTS: The proportion of the ROP-randomized group with limitations in 4 attributes or more was 20.6% compared with 2.0% for the no-ROP group. Within the ROP-randomized group, the proportion of "sighted" children with limitations in 4 attributes or more was 6.4% vs 46.5% in the "blind/low vision" group. The median HRQL score for the ROP-randomized children was lower than for the no-ROP children (0.72 vs 0.97, P<.001); the median HRQL score for the sighted-randomized children was 0.87 vs 0.27 for the blind/low vision children (P<.001). CONCLUSIONS: Threshold ROP was associated with functional limitations in health attributes and reduction in HRQL scores at age 10 years. Furthermore, among children who developed threshold ROP, a greater reduction in HRQL scores was found among children with a poor visual outcome compared with those with better sight.

Role of vision on early motor development: lessons from the blind.

For a better understanding of the contribution vision makes to the development of other sensory systems and to movement and posture, we studied effects of early blindness by examining video recordings of 14 totally blind infants. Infants were born at term or preterm and showed no evidence of brain damage. During preterm and term periods no noticeable changes in motor activity were observed. Around 2 months postterm all infants showed clear delay in head control and abnormal, exaggerated type of 'fidgety movements'. Later, postural control was characterized by a prolonged period of ataxic features. Results indicate a lack of normal calibration exerted by vision on proprioceptive and vestibular systems. Early visuomotor coordination such as coordinated eye-head scanning and head orientating were present but disappeared after several weeks.