[Evaluation of Ophthalmic Follow-up Care of Former Pre-term and Full-term Infants Aged from 4 to 10 Years in Germany - Results of the Wiesbaden Prematurity Study (WPS)].

Abstract:

BACKGROUND:The purpose of this investigation was to analyse the ophthalmic follow-up care of former pre-term and full-term born infants aged 4 to 10 years in the clinical practice and the comparison to the recommendations of the national ophthalmic guidelines. METHODS:For the prospective Wiesbaden Prematurity Study (WPS), 503 infants were examined: 239 former pre-term infants (PT) with gestational age (GA) ≤ 32 weeks and 264 former full-term born infants (FT) with a GA ≥ 37 weeks aged 4 to 10 years. Ophthalmic examination was performed including refractive measurements and orthoptic examination. Anisometropia was defined as a difference of ≥ 1 D spherical equivalent. Data was assessed if an ophthalmological examination was performed after hospital discharge, and how many times the ophthalmologist was contacted within the last 12 months. RESULTS:Overall, strabismus and anisometropia were present in 18 and 10% of all PT, and in 2 and 5% of all FT infants, respectively. In infants aged 4 to 6 years, 65% of all former PT and 42% of all former FT had ophthalmological contacts within the last year (p = 0.002). 15% of the pre-term infants with strabismus did not have an ophthalmological examination within the last year. The parents of three former pre-term infants reported that they never had an ophthalmologic examination after hospital discharge. CONCLUSION:Two-thirds of the former pre-term infants participated in a screening examination at the age of 4 to 6 years in the last year according to their parents, which is recommended by the guidelines for the care of former pre-term infants. There is still room for improvement to provide best ophthalmological care for this vulnerable population that have high risk for strabismus and amblyopia. HINTERGRUND:Ziele der vorliegenden Untersuchung waren die Evaluation ophthalmologischer Nachsorgeuntersuchungen ehemaliger früh- und reifgeborener Kinder im Alter von 4 bis 10 Jahren und der Vergleich mit den deutschen Leitlinien. METHODIK:In der prospektiven Wiesbaden Prematurity Study (WPS) wurden 503 Kinder, davon 239 Frühgeborene (FG) mit Gestationsalter (GA) ≤ 32 Wochen und 264 Reifgeborene (RG) mit GA ≥ 37 Wochen (Kontrollgruppe) im Alter von 4 bis 10 Jahren inklusive Refraktionsmessung und orthoptischem Status untersucht. Anisometropie war definiert als Refraktionsunterschied von ≥ 1 dpt sphärischem Äquivalent. Die Eltern wurden zusätzlich gefragt, ob nach der Entlassung aus dem Krankenhaus eine augenärztliche Untersuchung stattgefunden habe und wie oft eine solche innerhalb der letzten 12 Monate durchgeführt wurde. ERGEBNIS:Insgesamt zeigten sich ein Strabismus bzw. eine Anisometropie bei 18 bzw. 10% aller FG- und 2 bzw. 5% aller RG-Kinder. Von den 4 bis 6 Jahre alten FG waren 65% und von den 4 bis 6 Jahre alten RG 42% innerhalb der letzten 12 Monate bei einer augenärztlichen Untersuchung (p = 0,002). Bei 15% aller Kinder mit Strabismus war innerhalb der letzten 12 Monate keine augenärztliche Untersuchung erfolgt. Die Eltern von 3 frühgeborenen Kindern berichteten nach der Entlassung aus dem Krankenhaus, nie bei einer augenärztlichen Kontrolluntersuchung gewesen zu sein. SCHLUSSFOLGERUNG:Zwei Drittel der ehemaligen FG nahmen nach Aussage der Eltern im Alter von 4 bis 6 Jahren innerhalb der letzten 12 Monate an einer augenärztlichen Kontrolluntersuchung teil, was in den Leitlinien für die Versorgung ehemaliger frühgeborener Kinder empfohlen wird. Hier zeigt sich noch Verbesserungspotenzial, um diese Risikopopulation, insbesondere für Strabismus und Amblyopie, bestmöglich zu versorgen.

journal_name

Klin Monbl Augenheilkd

authors

Fieß A,Kölb-Keerl R,Elflein HM,Schuster AK,Knuf M,Kirchhof B,Oberacher-Velten I,Muether PS,Bauer J

doi

10.1055/s-0043-118852

subject

Has Abstract

pub_date

2019-10-01 00:00:00

pages

1174-1181

issue

10

eissn

0023-2165

issn

1439-3999

journal_volume

236

pub_type

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