Impaired cognitive ability at 2.5 years predicts later visual and ophthalmological problems in children born very preterm

Aim: To identify possible predictive factors for visual problems at 6.5 years in children born very preterm. Methods: During 2004-2007, all very preterm infants (gestational age [GA] < 32 weeks) in Uppsala County, Sweden were screened for retinopathy of prematurity (ROP) neonatally; at four months, visual tracking was tested; at 2.5 years, visuospatial and cognitive tests were carried out. At 6.5 years, 84 preterm children and a reference group of 64 full-term children underwent ophthalmological testing. Results: Mean visual acuity (VA) did not differ between the groups, but subnormal VA (<= 0.8) was more common in the preterm group (31% vs 14%; p < 0.05). More often than full-term children, preterm children had impaired contrast sensitivity (<0.5) (36% vs 19%; p < 0.05) and strabismus (8% vs 0%; p < 0.05). Low GA, ROP, intraventricular haemorrhage 3-4/periventricular leukomalacia and cognitive disability at 2.5 years predicted ophthalmological and visual problems at 6.5 years. Visual tracking ability at four months was not predictive of ophthalmological outcome. Conclusion: Children born preterm had more ophthalmological problems at 6.5 years of age, including subtle dysfunctions. ROP, early brain injury and impaired cognitive function around 2.5 years predicted later ophthalmological dysfunctions.