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Ophthalmologic Outc...
Ophthalmologic Outcome of Extremely Preterm Infants at 6.5 Years of Age Extremely Preterm Infants in Sweden Study (EXPRESS)
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- Källén, Karin (author)
- Karolinska Institutet,Lund University,Lunds universitet,Karolinska Institute,Kardiovaskulär forskning - epidemiologi,Forskargrupper vid Lunds universitet,Cardiovascular Research - Epidemiology,Lund University Research Groups,Centre of Reproduction Epidemiology, Department of Obstetrics and Gynecology, Institute of Clinical Sciences, University of Lund, Lund, Sweden,Lund Univ, Dept Obstet & Gynecol, Ctr Reprod Epidemiol, Lund, Sweden.
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- Tornqvist, Kristina (author)
- Lund University,Lunds universitet,Oftalmologi, Lund,Sektion IV,Institutionen för kliniska vetenskaper, Lund,Medicinska fakulteten,Ophthalmology, Lund,Section IV,Department of Clinical Sciences, Lund,Faculty of Medicine,Department of Ophthalmology, Lund University Hospital, Lund, Sweden,Univ Lund Hosp, Dept Ophthalmol, S-22185 Lund, Sweden.
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- Jakobsson, Peter (author)
- Linköpings universitet,Linköping University,Department of Clinical and Experimental Medicine, Linköping University, Linköping, Sweden,Avdelningen för neuro- och inflammationsvetenskap,Medicinska fakulteten,Region Östergötland, Ögonkliniken US,Linkoping Univ, Dept Clin & Expt Med, Linkoping, Sweden.
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- Lundgren, Pia, 1967- (author)
- Umeå universitet,Umeå University,Department of Ophthalmology, Umeå University, Umeå, Sweden,Oftalmiatrik,Umea Univ, Dept Ophthalmol, S-90187 Umea, Sweden.
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- Carlsson, B. (author)
- Örebro University,Department of Ophthalmology, Örebro University, Örebro, Sweden,Univ Orebro, Dept Ophthalmol, SE-70182 Orebro, Sweden.
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Kallen, K. (author)
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- Serenius, Fredrik (author)
- Uppsala universitet,Uppsala University,Section of Pediatrics, Department of Women's and Children's Health, Uppsala University, Uppsala, Sweden,Pediatrik
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- Hellström, Ann, 1959 (author)
- University of Gothenburg,Gothenburg University,Göteborgs universitet,Institutionen för kliniska vetenskaper, Avdelningen för pediatrik,Institute of Clinical Sciences, Department of Pediatrics,Section of Pediatric Ophthalmology, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden,Univ Gothenburg, Sahlgrenska Acad, Sect Pediat Ophthalmol, Gothenburg, Sweden.
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- Holmström, Gerd (author)
- Uppsala universitet,Uppsala University,Department of Neuroscience (Ophthalmology), Uppsala University Hospital, Uppsala, Sweden,Oftalmiatrik
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- Hellgren, Kerstin M. (author)
- Department of Clinical Neuroscience, Karolinska Institutet, Astrid Lindgren Children's Hospital, Stockholm, Sweden,Astrid Lindgren Childrens Hosp, Dept Clin Neurosci, Karolinska Inst, MBC, Polhemsgatan 56, S-11282 Stockholm, Sweden.
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(creator_code:org_t)
- American Medical Association (AMA), 2016
- 2016
- English.
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In: Jama Ophthalmology. - : American Medical Association (AMA). - 2168-6165 .- 2168-6173. ; 134:5, s. 555-562
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Abstract
Subject headings
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- IMPORTANCE This follow-up study of extremely preterm (EPT) children (<27 weeks' gestational age [GA] at birth) revealed major eye and visual problems in 37.9%(147 of 388) of all EPT infants and in 55.4%(67 of 121) of the most immature subgroups at 6.5 years of age. These major eye and visual problems were strongly associated with treatment-requiring retinopathy of prematurity (ROP). OBJECTIVES To investigate the ophthalmologic outcome of a national cohort of EPT children at 6.5 years of age and to evaluate the impact of prematurity and ROP. DESIGN, SETTING, AND PARTICIPANTS All surviving EPT children born in Sweden between April 1, 2004, and March 31, 2007, were included and compared with a matched term control group, as part of a prospective national follow-up study. MAIN OUTCOMES AND MEASURES Visual acuity, refraction in cycloplegia, and manifest strabismus were evaluated and compared with GA at birth and with treatment-requiring ROP. RESULTS The study cohort comprised 486 participants. The mean (SD) GA of the children who were included was 25 (1) weeks, and 45.7%(222 of 486) were female. At a median age of 6.6 years, 89.3%(434 of 486) of eligible EPT children were assessed and compared with 300 control group children. In the EPT group, 2.1%(9 of 434) were blind, 4.8%(21 of 434) were visually impaired according to the World Health Organization criteria, and 8.8% (38 of 434) were visually impaired according to the study criteria. Strabismus was found in 17.4% (68 of 390) and refractive errors in 29.7%(115 of 387) of the EPT children compared with 0% (0 of 299) and 5.9% (17 of 289), respectively, of the control children (P<.001). Altogether at 6.5 years of age, 37.9%(147 of 388) of the EPT children had some ophthalmologic abnormality compared with 6.2%(18 of 290) of the matched control group (95% CI of the difference, 26.1%-37.2%). When treatment-requiring ROP was adjusted for, no significant association between GA and visual impairment could be detected. For refractive errors, the association with GA remained after adjustment for treatment-requiring ROP (odds ratio, 0.72; 95% CI, 0.58-0.91 for each 1-week increment). CONCLUSIONS AND RELEVANCE In a Swedish national cohort of EPT children at 6.5 years of age, major eye and visual problems were frequently found. Treatment-requiring ROP was a stronger impact factor than GA on visual impairment and strabismus, but not on refractive errors, as a whole. In modern neonatal intensive care settings, ophthalmologic problems continue to account for a high proportion of long-term sequelae of prematurity.
Subject headings
- MEDICIN OCH HÄLSOVETENSKAP -- Klinisk medicin -- Pediatrik (hsv//swe)
- MEDICAL AND HEALTH SCIENCES -- Clinical Medicine -- Pediatrics (hsv//eng)
- MEDICIN OCH HÄLSOVETENSKAP -- Klinisk medicin -- Oftalmologi (hsv//swe)
- MEDICAL AND HEALTH SCIENCES -- Clinical Medicine -- Ophthalmology (hsv//eng)
- MEDICIN OCH HÄLSOVETENSKAP -- Klinisk medicin (hsv//swe)
- MEDICAL AND HEALTH SCIENCES -- Clinical Medicine (hsv//eng)
Keyword
- full-term children
- 6-year-old australian children
- prematurity
- randomized-trial
- population-based sample
- active perinatal-care
- visual-acuity
- 10-year-old preterm
- retinopathy
- born
- strabismus
- Ophthalmology
Publication and Content Type
- ref (subject category)
- art (subject category)
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- By the author/editor
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Källén, Karin
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Tornqvist, Krist ...
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Jakobsson, Peter
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Lundgren, Pia, 1 ...
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Carlsson, B.
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Kallen, K.
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Serenius, Fredri ...
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Hellström, Ann, ...
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Holmström, Gerd
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Hellgren, Kersti ...
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- About the subject
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- MEDICAL AND HEALTH SCIENCES
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MEDICAL AND HEAL ...
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and Clinical Medicin ...
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and Pediatrics
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- MEDICAL AND HEALTH SCIENCES
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MEDICAL AND HEAL ...
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and Clinical Medicin ...
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and Ophthalmology
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Jama Ophthalmolo ...
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University of Gothenburg
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Lund University
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Örebro University
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Umeå University
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Linköping University
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Karolinska Institutet
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Uppsala University
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