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Strabismus in Premature Infants in the First Year of Life
Don L. Bremer, MD;
Earl A. Palmer, MD;
Rae R. Fellows, MEd;
John D. Baker, MD;
Robert J. Hardy, PhD;
Betty Tung, MS;
Gary L. Rogers, MD;
for The Cryotherapy for Retinopathy of Prematurity Cooperative Group
Arch Ophthalmol. 1998;116:329-333.
Objectives To present the 3- and 12-month strabismus data from 3030 premature infants with birth weights less than 1251 g enrolled in the Multicenter Trial of Cryotherapy for Retinopathy of Prematurity.
Design Data from the 3- and 12-month examinations conducted at 23 regional study centers were tabulated for all infants. The main outcome measure, ocular motility, was compared with baseline demographic variables and retinopathy of prematurity severity for the worse eye. Findings at 3 months were compared with the incidence of strabismus at 12 months.
Results At 3 months, 200 (6.6%) of the 3030 infants were strabismic. In the 2449 infants examined at both time points, 289 (11.8%) were found to have strabismus at 12 months. Retinopathy of prematurity was significant for strabismus at both 3 and 12 months (P<.001). The presence of strabismus at 3 months was found to be a highly significant predictor of strabismus at 12 months. Anisometropia, abnormal fixation, and unfavorable retinal structure also were significant predictors of strabismus at 1 year. The total prevalence of strabismus in the first year of life was 14.7%.
Conclusion The presence of acute-phase retinopathy of prematurity places the premature infant at increased risk for strabismus.
From the Children's Hospital (Drs Bremer and Rogers and Ms Fellows) and the Department of Ophthalmology, Ohio State University (Drs Bremer and Rogers), Columbus; Casey Eye Institute, Oregon Health Sciences University, Portland (Dr Palmer); William Beaumont Hospital and Children's Hospital of Michigan, Detroit (Dr Baker); and the School of Public Health, Coordinating Center for Clinical Trials, University of Texas Health Science Center, Houston (Dr Hardy and Ms Tung). A complete listing of the members of the Cryotherapy for Retinopathy of Prematurity Cooperative Group was published previously (Arch Ophthalmol. 1996;114: 417-424).
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