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Vision in former very low birthweight young adults with and without retinopathy of prematurity compared with term born controls: the NZ 1986 VLBW follow-up study
  1. Brian A Darlow1,
  2. Mark J Elder2,
  3. Bridget Kimber1,
  4. Julia Martin1,
  5. L John Horwood3
  1. 1 Department of Paediatrics, University of Otago, Christchurch, New Zealand
  2. 2 Department of Surgery, University of Otago, Christchurch, New Zealand
  3. 3 Christchurch Health and Development Study, University of Otago, Christchurch, New Zealand
  1. Correspondence to Professor Brian A Darlow, Department of Paediatrics, University of Otago, Christchurch 8140, New Zealand; brian.darlow{at}


Objective There are few data on visual outcomes in adulthood of former very low birthweight (VLBW; <1500 g) infants. We aimed to assess vision at 27–29 years in a national cohort of VLBW infants born in 1986 and assessed for retinopathy of prematurity (ROP) when no treatment was available, compared with term born controls.

Methods The cohort and controls attended a 2-day assessment in Christchurch as part of a larger study. Visual assessment included glasses prescription measured by focimeter, logarithm of the minimum angle of resolution (logMAR) distance visual acuity (VA), contrast sensitivity, autorefraction, retinal photographs and a questionnaire on vision-related everyday activities. Rates of reduced VA and myopia in the VLBW cohort at 27–29 were compared with the results of vision testing at 7–8 years.

Results 250 VLBW adults (77% those alive) gave study consent and 229 (45 with a history of ROP) were assessed in Christchurch, plus 100 term born controls. VLBW adults with ROP had reduced VA compared with no ROP and controls (mean logMAR score (SD); 0.003 (0.19), –0.021 (0.16), –0.078 (0.09), P=0.001). There were no differences in myopia (>2 D) between the groups but high myopia (>5 D) was confined to those with ROP. VLBW adults with ROP drove a car less often and had higher difficulties with everyday activities scores due to eyesight. Between 7–8 and 27–29 years rates of reduced VA were stable but myopia increased.

Conclusion Former VLBW young adults with ROP have ongoing problems with vision affecting daily living and should continue in regular ophthalmological review.

Trial registration number ACTRN12612000995875, Pre-results .

  • retinopathy of prematurity
  • very low birthweight
  • young adult outcomes
  • visual impairment

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  • Contributors BAD conceptualised and designed the study, contributed to the interpretation of data, drafted the initial manuscript and approved the final manuscript as submitted. MJE, BK, JM and LJH contributed to the concept, design and interpretation of data, critically reviewed and revised the draft manuscript for intellectual content and approved the final submitted version of the article. All authors agree to be accountable for all aspects of the work presented, including the accuracy and integrity of the findings reported. BAD had full access to all the data in the study and takes responsibility for the integrity of the data and the accuracy of the data analysis.

  • Funding The study was funded by the New Zealand Health Research Council (12/129) through a competitive project grant with some co-funding from the Cure Kids charity. Additional funding was from two project grants from the Child Health Research Foundation (Cure Kids) (CHRF 5040, 5041).

  • Competing interests None declared.

  • Ethics approval The study was approved by the Southern Health and Disability Ethics Committee (NZ).

  • Provenance and peer review Not commissioned; externally peer reviewed.

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